Originally Published in The Intercept
John Washington and José Olivares - October 27, 2020
Advocates briefed senators on allegations that a doctor working with an ICE detention center performed unnecessary or overly aggressive procedures.
AT LEAST 17 women treated by a doctor alleged to have performed unnecessary or overly aggressive gynecological procedures without proper informed consent remain in detention at Irwin County Detention Center, a privately run facility in Georgia housing U.S. Immigrations and Customs Enforcement detainees, according to a briefing and written materials submitted by attorneys and advocates to Senators in a closed-door meeting on Capitol Hill. The total number of women known to have been seen by the doctor since 2018 who say they underwent or were pressured to undergo unnecessary treatments has risen to 57 — a higher number than previously known — according to the group of lawyers.
The new numbers of relevant cases and women who remain in detention were included in the materials submitted to the closed-door meeting on Capitol Hill about the ordeal over women’s medical care at Irwin. Organized by the Senate Democratic Caucus, attorney Sarah Owings of Owings MacNorlin law firm in Atlanta, two women previously detained in Irwin, and four independent doctors presented recent findings, including more than 60 pages of written materials, in a Monday briefing for the senators. The briefings came as part of Congressional investigations into the allegation, which Democratic leaders in both houses of Congress have pledged to look in to.
As the number of women alleging medical misconduct at Irwin, which is run by the private prison company LaSalle Corrections, grows, advocates for detainees worry that there may never be a full accounting. The numbers presented to the Senate on Monday were limited to only those cases lawyers could identify, the advocates said. Because of the opacity of the immigration system and the constant flux of detainees — as well as the deportation of witnesses and survivors — a comprehensive review is unlikely.
“It pains me to know that there could be many more women out there who will never be able to talk about what happened to them and the abuse that they suffered while at Irwin, let alone receive a measure of redress, while living with the life-long damage to their bodies and spirits,” said Azadeh Shahshahani, the legal and advocacy director of Project South, which first raised the issues in a whistleblower complaint. “ICE and the private prison corporation LaSalle must be held to account.”
In the Senate briefing, the doctors and former detainees outlined a pattern of gynecological operations conducted by Dr. Mahendra Amin, the doctor at the center of the allegations, and the “uniform absence of truly informed consent,” according to materials submitted on Capitol Hill by the coalition of attorneys, advocates, and women recently detained in Irwin. After allegations of the medical abuses came to light in September, following the whistleblower complaint first reported by The Intercept, ICE said it stopped referring patients to Amin.
The materials submitted to Congress were compiled by on-the ground organizations; attorneys, including Owings; and advocates, led by the South Georgia Immigrant Support Network, Project South, the Georgia Latino Alliance for Human Rights, Georgia Detention Watch, and the Southern Poverty Law Center’s Southeast Immigrant Freedom Initiative.
In response to an inquiry from The Intercept about the growing numbers of women alleging medical misconduct and congressional interest in the case, Amin’s lawyer, Scott Grubman, sent a statement responding to a Los Angeles Times story published last week about a medical review of some of the immigration detainees’ cases. In the statement, Grubman, who said the doctor could not comment on individual cases because of privacy regulations, claims that there are “serious questions to the veracity” of the LA Times reporting, specifically citing that the team of medical experts didn’t request medical records from Irwin County Hospital or Amin himself. (Records of medical procedures are also maintained by ICE and can be requested by attorneys or detainees.)
Grubman, who did not respond to specific follow-up questions from The Intercept, has maintained throughout the ordeal that Amin is cooperating with investigators and that the doctor will be cleared of any wrongdoing.
The widespread attention on the women at Irwin has amplified calls for better medical care in immigration detention, where there has been adramatic increase in deaths over the past year. Advocates for immigration detainees have long complained of dangerously poor medical care in the sprawling patchwork of often privately run detention facilities.
Initial reports estimated that 20 or more women detained in Irwin had undergone full or partial hysterectomies in the last six years. Amin and his attorney dispute the claims. New information collected by attorneys and advocates who spoke with The Intercept — and who presented their findings to the Senate, including the written materials, which The Intercept reviewed — points to a broader pattern of women being pressured to undergo potentially unnecessary procedures.
Overall, the attorneys counted 57 confirmed patients of Amin, 17 of whom remain at Irwin as of October 25. (The Intercept was able to speak with attorneys who represented at least 52 of those women.) None of them have received any follow-up gynecological care since ICE stopped sending patients to Amin five weeks ago.
“The recent allegations by the independent contracted employee raise some very serious concerns that deserve to be investigated quickly and thoroughly,” said Tony Pham, ICE’s acting director, in a statement to The Intercept. Pham said ICE welcomes efforts of both the Department of Homeland Security, ICE’s parent agency, as well as the department’s Office of Inspector General to investigate. The statement concluded, “If there is any truth to these allegations, it is my commitment to make the corrections necessary to ensure we continue to prioritize the health, welfare and safety of ICE detainees.”
The Senate briefing comes on the heels of an independent medical review led by the ALLGOOD Foundation. The review, which was first reported in the LA Times article, was conducted by nine board-certified OB-GYNs and two nursing experts who reviewed over 3,200 pages of medical records for 19 of the women who had alleged medical misconduct by Amin. The team, according to their report, found “a disturbing pattern of aggressive treatment, including ‘overcalling’ the need for invasive surgeries, unwarranted pressure to undergo surgery, and a failure to obtain informed consent.”
“Not Something You Can Go Back From”
Over the past five weeks, since the whistleblower complaint emerged, a steady stream of women who visited with Amin have shared their stories with the press. One, Jamileth, whose name has been changed for fear of retaliation, told The Intercept that Amin did procedures on her without getting her permission. In May, amid a nine-month stint at Irwin, she began experiencing stomach pain and irregular periods. The ICE detention center sent her to Amin.
“He did a vaginal ultrasound, but he didn’t ask me if I wanted one or not. He just did it,” Jamileth told The Intercept in Spanish. “I don’t know, he treated me in a very — well, in a very rough way.”
According to Jamileth, Amin said she had an ovarian cyst. She said he asked if he could give her an injection — Jamileth does not know for what — and then suggested surgery to remove the cyst. Jamileth refused both the injection and the operation, saying she needed to consult with her family first. In the end, she refused to see Amin again.
“I didn’t want to return, because I had seen other examples,” Jamileth said, explaining that she had seen other women in detention after visits with Amin. She described, in one instance, seeing a woman return from surgery: “She was bleeding through the wound, she was purple, black in her stomach, and it looked really bad.”
Several women told their attorneys they were prescribed Depo-Provera, a hormonal birth control shot with sometimes serious side effects, without their consent. One woman, after her operation and shot of Depo-Provera, was “still unclear what exactly happened to her body,” according to the briefing materials provided to Senate Democrats. There were a number of cases that resulted in lasting confusion. One woman was deported to El Salvador and thinks that she had a hysterectomy but remains unsure, according to the materials provided to senators.
Another woman went to Amin for pain she suspected resulted from having fibroid cysts removed from her uterus before her time in detention, according to the Senate briefing. Amin administered three shots to her, explaining they were “for the pain,” according to her recollection in the briefing. Only after she was returned to Irwin did she learn from a nurse there that she had been given Depo-Provera.
When the woman asked about the shots at a follow-up appointment, Amin got defensive. “I’m trying to help you,” he said, according to the testimony in the briefing. He later pressured her into submitting to a hysterectomy, the testimony said, telling the detainee, “You’re an old woman, why would you want to have more babies?” She refused the surgery.
Yet another woman said she felt lucky when she was diagnosed with Covid-19 — the detention center failed to take basic precautionary measures, refused to test symptomatic detainees, and underreported cases of Covid-19, according to the earlier whistleblower report — and her hysterectomy was delayed. ”I felt like I didn’t have control over my life,” she said. She eventually refused the surgery and was deported.
The medical review of pathology reports conducted by ALLGOOD showed “a pattern of overly aggressive care,” including “inappropriate, unconsented transvaginal procedures,” “exaggerated interpretations of imaging results,” and less invasive methods not being pursued.
Attorney Benjamin Osorio, who represents two of the women tallied in the Senate briefing, said in an interview with The Intercept that one of his clients was told a hysterectomy was the only possible option to remove a possibly cancerous cyst. “There are less invasive, less aggressive treatments, but he took out her whole reproductive system,” Osorio explained “That’s not something you can go back from.”
The Intercept spoke to Yuridia, who was deported three days after undergoing an operation she said she did not comprehend and did not consent to. She was dumped into Mexico not knowing what happened to her, still bleeding, wondering if she still had a uterus, her attorney Kathleen Hoyos told The Intercept. It was a month before Yuridia, who asked to be identified by her first name because of an ongoing immigration case, was able to see a gynecologist in Mexico and learn what had happened to her. (She had been given a shot of a hormonal contraceptive and underwent a dilation and curettage to remove a cyst.) Hoyos said, “All she knew was what happened to her was wrong.”
Deportations Concern Congress
Since the initial whistleblower report was submitted in September, ICE has deported at least five women who were seen by Amin. At least two more women may be deported this week, according to the Senate briefing. “ICE, LaSalle, and DHS are ensuring fewer witnesses are able to participate in the pending federal investigation,” the Senate briefing materials say.
Members of Congress are taking note. “Advocates have shared with my team that many of the women who questioned Dr. Amin’s advice were quickly deported, and that many others at the facility are now fearful of seeking medical care at all,” Sen. Jeff Merkley, D-Ore., said in a statement to The Intercept. “We need a full accounting of what has been done to the women at Irwin, so we can hold perpetrators of any horrific actions accountable, and give the American people the answers they deserve.”
Last Friday, eight members of Congress, including Reps. Alexandria Ocasio-Cortez, D-N.Y.; Ilhan Omar, D-Minn.; Rashida Tlaib, D-Mich.; and Ayanna Pressley, D-Mass., sent a letter to United Nations High Commissioner for Human Rights Michelle Bachelet outlining concerns about gynecological procedures on women in Irwin. They requested that Bachelet lead an investigation into the procedures conducted on immigrant women.
“These allegations illustrate a clear pattern of alleged human rights violations by DHS,” the letter says. “This pattern of behavior is perpetuated and encouraged by the consistent and unforgivable failure of the United States government and its institutions to take these allegations seriously by investigating them in a transparent, thorough, and impartial manner.”
Last week, Rep. Hank Johnson, D-Ga., also sent a letter to ICE, along with Ocasio-Cortez and Rep. Adriano Espaillat, D-N.Y., demanding that Irwin be shut down.
One detained woman quoted in Monday’s Senate briefing materials also called for Irwin to be shut down, adding, “We could die locked up in here.”