Female ICE Detainees Had 'Excessive, Invasive and Unnecessary Procedures,' Report Finds

Democratic Sen. Jon Ossoff unveiled the findings of an investigation centered on an OB-GYN and a detention facility in Georgia at a Capitol Hill hearing.

A congressional investigation into medical abuse allegations at a Georgia immigration detention center found that female detainees “appeared to have undergone excessive, invasive, and often unnecessary gynecological procedures,” according to the report released Tuesday.

Sen. Jon Ossoff (D-Ga.), chair of the Senate Homeland Security subcommittee on investigations, presented the findings of the 108-paged report, which came after an 18-month bipartisan investigation by the committee, during a Tuesday hearing. Immigration officials; the Department of Homeland Security inspector general; LaSalle Corrections, the private company operating the Ocilla, Georgia, facility; as well as a former immigrant detainee and physicians provided testimony.

Though the subcommittee said it did not substantiate allegations of mass hysterectomies, the report concluded that female detainees underwent excessive and unnecessary gynecological procedures and that “medical care provided to detainees was known by DHS to be deficient, but neither ICE nor LaSalle took effective corrective action.”

“U.S. Immigration and Customs Enforcement (ICE) is committed to ensuring all those in its custody receive appropriate medical care and are treated with respect and dignity,” a spokesperson for Immigration and Customs Enforcement told HuffPost via an emailed statement.

The spokesperson added that the agency is fully cooperating in all the investigations, including Congress’, and “took immediate steps to discontinue sending patients in our custody to this offsite provider and to pursue alternative providers to serve ICDC’s female population” until it fully ceased operations at the facility.

In September 2020, a whistleblower alleged that women at the Irwin County Detention Center (ICDC) in Ocilla had been serially coerced into unwanted and unnecessary surgeries by Dr. Mahendra Amin, a physician who worked frequently at the facility, in many cases without the consent of the detainees.

Later that month, an investigation by The Associated Press found more allegations from migrant women who said that Amin performed surgeries and other procedures that they never sought or didn’t fully understand.

The complaint submitted by Dawn Wooten, a nurse at the facility who sounded an alarm about medical abuse, garnered national attention and generated concerns from congressional Democrats. In May 2021, the Biden administration announced it would stop detaining immigrants at the Irwin County Detention Center. Secretary of Homeland Security Alejandro Mayorkas also directed ICE to sever its contracts with LaSalle Corp. “as soon as possible.” LaSalle Corrections continues to run the facility under a contract with the U.S. Marshals Service.

LaSalle Corrections did not respond to HuffPost’s request for comment.

Dawn Wooten, a nurse at Irwin County Detention Center in Ocilla, Georgia, speaks at a Sept. 15, 2020, news conference in Atlanta protesting conditions at the immigration jail. Wooten says authorities denied COVID-19 tests to immigrants, performed questionable hysterectomies and shredded records in a complaint filed to the Department of Homeland Security's inspector general.
Dawn Wooten, a nurse at Irwin County Detention Center in Ocilla, Georgia, speaks at a Sept. 15, 2020, news conference in Atlanta protesting conditions at the immigration jail. Wooten says authorities denied COVID-19 tests to immigrants, performed questionable hysterectomies and shredded records in a complaint filed to the Department of Homeland Security's inspector general.
Jeff Amy/Associated Press

Dr. Peter Cherouny, an OB-GYN physician who previously conducted medical reviews for the Department of Health and Human Services and spearheaded Tuesday’s report, found Amin’s use of certain surgical procedures to be “too aggressive and inappropriate.” He further concluded that Amin’s practices were “woefully behind the times” and that his treatment of ICDC detainees “is not meeting current standards of care.”

The report also noted that out of the 94 patient records examined, 40 of them indicated the patients had benign ovarian cysts removed by Amin, despite the fact that benign ovarian cysts “generally resolve without surgical intervention.”

Amin began treating detainees in 2014 at ICDC, the year after the Department of Justice filed its lawsuit against him. In 2015, Amin, other physicians and the county’s hospital authority entered into a settlement with the Justice Department and the State of Georgia, agreeing to pay $520,000 to resolve allegations regarding Medicaid fraud.

ICE was not aware of the publicly available information regarding medical malpractice suits and the fraud complaint against Amin before he began treating ICE detainees, noted the report.

“Dr. Amin has been practicing for nearly 40 years, and has never performed a procedure that was not, in his professional judgment, necessary and appropriate,” said Scott R. Grubman, Amin’s lawyer.

Grubman told HuffPost via email that “the Congressional Committee seems to have reached certain conclusions regarding Dr. Amin’s medical care without requesting a single medical record from Dr. Amin’s office, proving that the Committee was not at all interested in the truth, but simply scoring political points.”

According to the report, Amin performed a significantly higher volume of invasive procedures on ICE detainees compared with other OB-GYNs serving ICE detainees from 2017 to 2020, all while ICE continued to approve Amin’s performance and never identifying any of Amin’s treatments as potentially excessive or unnecessary.

Of all the gynecological visits by ICE detainees at its detention facilities nationwide from 2017 to 2020, Amin accounted for 6.5% of the visits, nearly one-third of certain OB-GYN procedures and more than 90% of some “key procedures,” despite the fact that ICDC housed only about 4% of the female detainee population, according to Tuesday’s report.

“Dr. Amin was a clear outlier in both the number and types of procedures he
performed compared to other OB-GYNs that treated ICE detainees,” the subcommittee’s report said.

Karina Cisneros Preciado, a 23-year-old former detainee at Irwin County Detention Center in Georgia, had an appointment with Amin during her time at the facility. She had recently given birth and hadn’t had her postpartum checkup, and she was experiencing stomach pains.

Her waist and ankles were in handcuffs when she was transferred to Amin’s office before she undressed for a pelvic exam. Preciado said Amin didn’t acknowledge her during the appointment except to tell her she had a cyst on her left ovary. In order to treat it, she was told, she was going to be given an injection and if the cyst didn’t dissolve she would be required to undergo surgery.

Amin gave Preciado a contraceptive injection, but she didn’t know it at the time. Preciado said if she knew, she would have refused due to a family history of reacting poorly to birth control medication.

“I didn’t say anything because I thought I couldn’t. I felt like I didn’t have control over my body,” she said.

After the injection, Preciado said, she was pressured to sign a document she couldn’t hold or read because of the handcuffs.

Shortly after, Preciado said her body changed so much that it scared her. She gained weight and her hormones fluctuated. Some days she just spent in bed crying, she said.

“I’m human too. I want them to feel what I feel,” Preciado said. “I’m not an animal. I’m not someone who doesn’t feel.”

Preciado who testified Tuesday alongside her lawyer and the director of Columbia Law School’s Immigrants’ Rights Clinic, Elora Mukherjee.

“Today’s hearing is a critical step forward in the investigation into the abuses of the Irwin County Detention Center, which are among the worst human rights abuses in modern American history. This subcommittee has been investigating the abuses at Erwin for about 18 months now. And we look forward to finally there being accountability for the suffering that Karina and countless other women have experienced,” Mukherjee said.

Investigators said Amin was under criminal investigation by the federal government as of earlier this year. Through his attorney, Amin submitted an affidavit stating that he declined to provide testimony, invoking his Fifth Amendment protection against self-incrimination. The subcommittee accepted Amin’s pleas and did not question him throughout the investigation, the report noted.

Additionally, the report found systematic failures by immigration officials that could have prevented the medical harms faced by detainees. ICE lacked a medical review process to help track such cases of abuse, fraud or waste. The agency also did not employ a vetting process for physicians treating detainees at facilities outside of the detention centers.

The ICE spokesperson told HuffPost that the agency will begin new initiatives regarding off-site medical providers, including the application of national care guidelines, transitioning to a new system to track suspicious billing, and reviewing policies regarding informed consent.

“The abuses at the Irwin County Detention Center are particularly extreme, but they are also emblematic of the abuses that take place in immigration detention centers nationwide every day. Human beings must not be treated like animals, like numbers, and as disposable people whose lives don’t matter,” Mukherjee said.

An independent medical review team of nine board-certified OB-GYNs affiliated with major academic medical centers and two nursing experts published its own report in October 2020, finding “patterns of aggressive and unethical care.”

“The most important is that these women did suffer mistreatment and the manner in which they were treated, exposed to aggressive and frankly, unnecessary or uneducated and inappropriate procedures,” said Dr. Margaret Mueller, one of the doctors on that review team who testified at the subcommittee hearing Tuesday.

A separate internal investigation by the Department of Homeland Security and a federal lawsuit related to medical procedures for immigrants detained at the Irwin County facility is ongoing.

“I don’t want this to happen to anyone else anymore. These jails should not even exist. They should all be shut down,” Preciado said.

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