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Following an 18-month investigation, a subcommittee in the United States Senate released a report that further confirmed whistleblower allegations that female detainees in the custody of Immigration and Customs Enforcement (ICE) were subject to invasive, harmful, and often unnecessary gynecological procedures.
Women in custody at the Irwin County Detention Center (ICDC) in Georgia, which was subsequently shut down by the Homeland Security Department, were referred by LaSalle Corrections to one single off-site obstetrician and gynecologist named Dr. Mahendra Amin.
“High rates” of procedures were carried out on dozens of ICE detainees without their informed consent.
“Amin accounted for roughly 6.5 percent of total OB-GYN visits among all ICE detainees in the same time period,” according to the subcommittee’s report [PDF]. “However, he performed nearly one-third of certain OB-GYN procedures on ICE detainees across the country between 2017 and 2020 and more than 90 percent of some key procedures.”
Dawn Wooten, who was a nurse at the detention center, played a critical role in spurring the investigation by making whistleblower disclosures [PDF] that exposed the medical abuse, which was regularly committed by Amin.
The US Senate's Homeland Security and Governmental Affairs Permanent Subcommittee on Investigations found that Amin held “no board certifications, and in 2013, the Department of Justice (DOJ) and the state of Georgia sued Dr. Amin, claiming he had committed Medicaid fraud by ordering unnecessary and excessive medical procedures.”
Amin settled in 2015, and along with his codefendants, “paid a $520 settlement to the federal government while admitting no wrongdoing.”
Yet ICE’s Health Service Corps hired Amin to provide medical care to detainees, including vulnerable women like Karina Cisneros Preciado, who testified at the subcommittee’s hearing on the “medical mistreatment of women in ICE detention" and was convened on November 15—the same day that the subcommittee's report was released.
'I Thank God That The News Came Out'
Preciado immigrated to the United States when she was eight years-old. She was the mother of a newborn baby that was born four months ago. Her daughter’s father abused her, and in June 2020, she called the police hoping they would stop the abuse. But despite the fact that Preciado had a black eye and bruises on her body, police arrested her instead of the person who was abusing her.
Charges against Preciado were eventually dropped. Still, she was detained at the Irwin County Detention Center for seven months. “It’s the worst place I have ever been in my life,” Preciado declared. She went from a mother to being a number—Prisoner 72176.
As Preciado recalled in her testimony, when she saw Amin, she expected to receive a pap smear, but Amin performed a vaginal ultrasound. He then claimed that she had a cyst on an ovary and gave her a shot to dissolve the cyst. “If it did not dissolve in a few weeks,” Preciado was told that she would need surgery.
A nurse gave Preciado a shot after she got dressed. She did not know what was injected into her body. She was handcuffed, and they had her sign a paper, which she was not given time to read. Preciado was put in a van for transportation back to the detention center.
“Back in the van, the other women asked me if I had gotten the shot to not have babies,” Preciado recalled. “That’s when I learned it was birth control, and if I would have known I would have said something as the women in my family had very bad experiences from birth control.”
“When we got back to ICDC, I learned the story of many other women that Dr. Amin told the same thing to. They all had cysts on their ovaries. They all got shots, and some of them got surgeries.”
“I thank God that the news came out because he didn’t get to do anything else to me,” Preciado added. “The reason I’m telling this story is because this shouldn’t happen to anyone, anymore. We’re not animals. We’re humans. We’re not just a number.”
No Proper Oversight Of ICE Doctors Like Amin
Stewart Smith, the assistant director for ICE’s Health Service Corps, was responsible for the off-site treatment that doctors like Amin provided detainees. But he told the subcommittee that the division was not aware that the DOJ had sued Amin for the exact abusive practices that later traumatized dozens if not hundreds of women.
According to Smith, Amin was the “only provider in the area that was willing to see these patients.” He said his division did not suspect Amin was doing anything improper until they learned of a whistleblower allegation.
“What I heard you say effectively is that you don’t vet [doctors], and if you had vetted, you wouldn’t catch this kind of thing,” Ossoff stated. To which Smith confirmed that they did not have a system in place for uncovering the necessary “derogatory information.”
A flabbergasted Ossoff replied, “We found that information quite swiftly. We found that the relevant provider had been sued by the federal government and the state government for excessive and unnecessary billing practices. We found that he’d been dropped by a major insurer for excessive malpractice claims. We found that he was not board certified.”
“These I think would have at least been warning signs to watch a little more carefully, and then during the relevant period he’s performing again 90 percent-plus of all of these gynecological surgeries nationwide, despite seeing only 6 percent of OB-GYN patients in the country,” Ossoff added.
Smith maintained that regional clinical directors for ICE’s Health Service Corps had vetted the gynecological procedures for appropriateness before detainees were sent off-site.
Ossoff responded, “How can that be when we’ve heard from medical experts who’ve reviewed thousands and thousands of pages of records? And it’s the bipartisan finding of the subcommittee that they weren’t appropriate. In fact, it’s not only that they weren’t appropriate. They were dangerous. They were wrong. They were not clinically indicated. They were poorly executed.”
“Women had parts of their cervixes removed. They underwent transvaginal ultrasounds and pap smears with no clinical indication for it. They underwent laparoscopic surgery when there was no need. They had their uterine lining and endometria [partly] removed,” Ossoff further stated.
Also baffling to Ossoff was the testimony of Pamela Hearn, the medical director for LaSalle Corrections, which oversaw the disgraceful facility.
Hearn attempted to argue ICE was entirely at fault for what happened with Amin. Yet she responded dishonestly to questions about the extent of a corporate review that was conducted by LaSalle.
“It took a team of professional investigators from both political parties here in the Senate eighteen months and consultation with a significant number of outside medical experts to go through tens of thousands of pages of medical records in order for us to arrive at these conclusions,” Ossoff said. “So how could a three-day review have possibly been sufficient for LaSalle to draw any conclusions about what happened here?”
Only three days were spent by LaSalle to examine what Amin did to women in their custody. Anything else reviewed was done in response to a subpoena for documents from the subcommittee, which Hearn tried to deceptively pass off as a part of some larger investigation that was never initiated.
'It's Hard For Me To Think Of Anything Worse, Really'
Amin stopped treating detainees from Irwin County Detention Center in September 2020, when allegations of abuse first emerged.
“The initial September 2020 whistleblower complaint alleged that Dr. Amin performed mass hysterectomies on ICDC detainees,” the subcommittee report recounted. While Wooten’s complaint prompted closer scrutiny of Amin’s actions, the subcommittee was not able to corroborate this allegation.
Nonetheless, the Office of the Inspector General for the Homeland Security Department launched an audit in October 2020 to investigate the medical care that was provided and also whether the facility had followed COVID-19 protocols. The process for approving gynecological procedures became a separate audit due to the “potential criminal nature.”
“In December 2020, several detainees filed a lawsuit against Dr. Amin, ICDC, ICE, and other parties alleging that Dr. Amin had subjected them to nonconsensual and unnecessary gynecological procedures as part of a broader pattern of medical abuse at ICDC.”
One year before Amin entered into a settlement with the Justice Department, he began providing services to detainees at Irwin County Detention Center.
The subcommittee spoke with six detainees who Amin treated. Each woman felt “confused, afraid, and violated after their encounters with Dr. Amin—and many of the women reported that they still live with pain and uncertainty regarding their fertility.”
Floriano Navarro, who shared her story with the subcommittee, “complained of painful menstrual cramps for about five to six months” before she saw Amin. “No one ever got my consent,” she told the subcommittee. She was “grateful that she understood English because otherwise she would not have known what was occurring.”
Like many of the women treated by Amin, on July 22, 2020, he chose to schedule Navarro for a surgery for a cyst, even though he could have waited to see if a hormonal medication commonly used as birth control and known as Depo-Provera had worked.
At one point, Navarro claims a guard told her she would have a hysterectomy. Fortunately, despite pressure from the detention center’s medical unit, Navarro had the will to “refuse the surgery due to her confusion.” She was deported to Mexico on September 16, 2020, without receiving any surgery.
“It’s hard for me to think of anything worse really, Dr. Smith, than the federal government subjecting incarcerated women to needless gynecological surgery,” Ossoff declared. “[It’s] one of the most appalling things this subcommittee has seen in the last two years.”
Preciado courageously shared more of her story. “It made me feel I had no control over my body. Before this experience, I had suffered from sexual assault before as a child.” What Amin did made her feel the same as she felt when she was assaulted.
“Because of this incident with what happened to Dr. Amin, to this day, I am extremely scared to go to any doctor—for myself and for my kids. It was extremely traumatic, and I don’t know if I could ever get over it.”
When Preciado was ripped away from her baby by cops, her daughter was a newborn. She came to see her after she was released from the detention center. Her daughter didn’t know who she was.
“She knew my mother as her mother. She was scared of me,” Preciado recalled, while breaking down into tears. “She wouldn’t come to me. It was hard, but it was the best moment because I got to see her again after so long.”
“I don’t want this to happen to any other women or any other person in general,” Preciado concluded. “They shouldn’t have to be separated from their family. They shouldn’t have to be scared to go to the doctor when we’re supposed to trust them.”
Multiple federal agencies were engaged in criminal investigations against Amin in early 2022, and Amin refused to voluntarily provide testimony to the subcommittee.
Amin invoked his privilege against self-incrimination after he received a subpoena from the subcommittee.