Senate report details medical mistreatment of female immigration detainees

The Washington Post / Maria Sacchetti, Nick Miroff

15:26 JST, November 16, 2022

Women held at a privately run immigration jail in Georgia were likely subjected to unnecessary gynecological procedures, and Immigration and Customs Enforcement authorities failed to halt a years-long pattern of what medical experts called “aggressive and unethical” treatment, according to a report published Tuesday by a bipartisan Senate panel.

The 108-page report, the result of an 18-month investigation, examined claims made by immigrant advocates and a whistleblower, Dawn Wooten, who worked as a nurse at the Irwin County Detention Center in rural Georgia.

The inquiry did not substantiate claims that women at the facility, operated by the for-profit company LaSalle Corrections, had been subjected to mass hysterectomies, as advocates initially claimed. But the investigation found Georgia physician Mahendra Amin appeared to have performed “excessive, invasive, and often unnecessary gynecological procedures” on dozens of women detained for deportation proceedings between 2017 and 2020.

Neither ICE nor La Salle Corrections took action until 2020, after the whistleblower came forward, the report said.

“Our findings are deeply disturbing,” Sen. Jon Ossoff (D-Ga.), chair of the Senate Homeland Security and Governmental Affairs Committee’s permanent subcommittee on investigations said at a hearing Tuesday.

Denouncing what he called “a catastrophic failure by the federal government to respect basic human rights,” Ossoff said Amin scheduled surgeries when less-invasive options were available, performed “unnecessary injections and treatments” and often proceeded without the patients’ informed consent.

Sen. Ron Johnson (R-Wis.), the ranking Republican on the subcommittee, and other GOP lawmakers were not at the hearing, but Johnson’s name was on the report and Ossoff thanked him and his staff for their work on the investigation.

From 2017 to 2020, Amin was the provider for 6.5 percent of all offsite obstetric and gynecological visits for ICE detainees nationwide. Yet he performed 82 percent of all “dilation and curettage” surgeries, 93 percent of all contraceptive injections, and 94 percent of all laparoscopic surgery to remove lesions.

“One doctor,” Ossoff said.

He said the subcommittee asked to interview Amin, then subpoenaed him when he refused. Ossoff said Amin invoked his Fifth Amendment right not to testify.

Amin’s lawyer, Scott Grubman, defended Amin in an email to The Washington Post. Amin has filed lawsuits against a media outlet and an author who publicized the allegations, saying the claims against him were false.

“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,” Grubman said in the email. “Curiously, 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.”

Grubman’s email did not respond to questions about why Amin took the Fifth or how Democratic or Republican lawmakers would gain politically from the report.

The Senate panel consulted with medical experts such as Peter Cherouny, an ob-gyn physician who previously conducted medical reviews for the Department of Health and Human Services and other federal agencies. Cherouny reviewed more than 16,600 pages of medical records that covered approximately 94 women treated by Amin, according to the report.

In the report, Cherouny found Amin’s use of certain procedures to be “too aggressive” and “woefully behind the times,” noting that Amin was not a board certified physician who would be required to remain up to date on the most current medical practices.

Cherouny said the care Amin provided was “pretty good medicine for the 1980s, but we’re not there anymore,” according to the report.

Former detainees held at the Irwin facility filed a class-action lawsuit in 2020 against the jail, ICE, Amin, the Irwin County Hospital and other parties alleging the detainees had undergone nonconsensual and unnecessary gynecological procedures.

Amin has not been charged criminally, though the report says he was “under criminal investigation by multiple federal agencies” as of early 2022. Department of Homeland Security Inspector General Joseph Cuffari, who also testified at the hearing, confirmed that multiple agencies are still investigating the matter, including his.

In emotional testimony, Karina Cisneros Preciado, a mother of two who lives in Florida, said she was taken to Amin for a post-partum checkup in 2020, while she was in immigrant detention for several months. She testified that she was arrested after calling the police to report that her partner abused her. Authorities dropped criminal charges against her, she said, then transferred her to ICE for civil deportation proceedings.

She had been brought to the United States at age 8 from Mexico, and had a four-month-old daughter at the time of her arrest.

During the appointment, she said, Amin barely acknowledged her, roughly examined her pelvis, diagnosed her with a cyst, and administered an injection. “Then he asks the nurse, ‘How many more?’ And he just walks off,” she told the Senate panel.

She said she signed a piece of paper but didn’t understand it.

Ossoff assailed Stewart Smith, assistant director of U.S. Immigration and Customs Enforcement Health Service Corps, for failing to properly vet Amin. The senator said Amin had previously been sued by the Justice Department and the state of Georgia for allegedly “performing excessive and unnecessary procedures,” had been dropped by a major insurer for “excessive malpractice claims” and was not board-certified.

“Are you not shocked that this happened under your watch?” Ossoff asked Smith, who called the testimony “very troubling.”

Smith said ICE learned from the whistleblower in September 2020 of allegations of “forced medical procedures” and conducted a review the next month. ICE did not find evidence of any such procedures, he said in his written testimony, but immediately stopped sending patients to Amin “out of an abundance of caution and due to the seriousness of the allegations.”

In May 2021, Homeland Security Secretary Alejandro Mayorkas said he would stop housing detainees at the Irwin County facility.

“ICE is firmly committed to ensuring all those in its custody receive appropriate medical care and are treated with respect and dignity,” Smith said in his written testimony.

Pamela Hearn, medical director for LaSalle Corrections, said the private company had a “limited role” in detaining immigrants and transferring them to nearby health-care providers selected by Smith’s office. In her written testimony, she said ICE “was solely authorized and responsible for vetting and credentialing all off-site medical providers to offer medical services to detainees.”

Ossoff told Smith that if the committee had been able to background-check Amin and quantify the disproportionate number of procedures he was performing, then ICE should have, too.

“The data was warning you, but you weren’t looking at it,” Ossoff said. “And a lot of people got hurt.”