Three nonprofit organizations filed a Freedom of Information Act (FOIA) lawsuit in October against U.S. Immigration and Customs Enforcement (ICE). The groups are demanding that the agency release records pertaining to alleged unnecessary gynecological procedures performed on immigrants in ICE custody at the Irwin County Detention Center in Georgia. The nonprofits – Citizens for Responsibility and Ethics in Washington, Project South and the National Immigration Project of the National Lawyers Guild – filed the lawsuit in U.S. District Court of the District of Columbia after previous FOIA requests to ICE went unanswered.
Suit stems from a whistleblower complaint
The lawsuit, Citizens for Responsibility and Ethics in Washington et al. v. U.S. Immigration and Customs Enforcement, stems from complaints sent by Project South and other advocacy groups to the U.S. Department of Homeland Security’s civil rights office and inspector general’s office in September. The complaints were based on testimony from whistleblower Dawn Wooten, a nurse who formerly worked at the facility, along with interviews from detainees.
The complaints alleged that the facility had unsafe social distancing, masking and sanitary practices and that it was denying proper medical care and COVID-19 testing to immigrants in custody. It also claimed that detained women were being given hysterectomies and other unnecessary gynecological procedures at a high rate and that many of them did not understand why they had been sent for the procedures.
Fallout from the complaint
The allegations about hysterectomies being performed without consent grabbed national headlines. More than 170 members of Congress sent a letter to the inspector general of the Department of Homeland Security demanding an immediate investigation.
Dr. Ada Rivera, medical director of the ICE Health Service Corps., said in a statement that ICE would fully cooperate with any resulting investigation by the Department of Homeland Security’s inspector general. But she asserted that only two full hysterectomies had been ordered for women in the center since 2018 and that “detainees are afforded informed consent, and a medical procedure like a hysterectomy would never be performed against a detainee’s will.”
The New York Times conducted an investigation that included consultations with five gynecologists, interviews with 16 women who were concerned about the gynecological care they had received at the center and reviews of the medical files of seven women who had managed to obtain their records. All of the women were treated by the detention center’s primary gynecologist, Dr. Mahendra Amin, according to the Times.
While acknowledging they might not have all the relevant information, the consulting gynecologists said that Dr. Amin generally overstated the size or risks associated with cysts or masses in the women’s reproductive organs and that he was consistently overaggressive in his treatment of the women’s conditions, routinely recommending surgical intervention even when less invasive treatments were an option. In almost all of the charts, the Times said, Dr. Amin listed symptoms such as heavy bleeding with clots and chronic pelvic pain, which could justify surgery, but some of the women said they never experienced or reported those symptoms.
“He is overly aggressive in his treatment and does not explore appropriate medical management before turning to procedures or surgical intervention,” Dr. Deborah Ottenheimer, a forensic evaluator and instructor at the Weill Cornell Medical School Human Rights Clinic, told the Times.
Both the women and the gynecologists also expressed concerns about whether Dr. Amin had adequately explained the procedures or provided his patients with less invasive options.
The Times article pointed out that Dr. Amin is paid by the procedure and that surgeries are billed at thousands of dollars each.
Dr. Amin’s attorney said in a statement that the doctor “strongly disputes any allegations that he treated any patient with anything other than the utmost care and respect” and that in every case the treatment was “medically necessary, performed within the standard of care and done only after obtaining full informed consent.”
FOIA lawsuit
In their FOIA lawsuit, the three nonprofit groups requested records on ICE’s policies related to gynecological medical procedures performed on detainees as well as consent protocols for patients undergoing a gynecological procedure. The groups also requested records related to the alleged “forced unnecessary procedures” carried out by Dr. Amin on at least 17 women at the center.
“The records we seek will shed light on these and other abuses at ICE detention centers across the country, as well as why ICE’s internal protocols failed to detect them,” Nikhel Sus, an attorney at Counsel for Citizens for Responsibility and Ethics in Washington, told the online publication Law360. “We are also seeking detailed complaint data about past instances of nonconsensual medical procedures at ICE detention centers, so we can get a better understanding of the scope of the problem.”
