Former Afghan ally who died in ICE custody suffered an allergic reaction, death certificate says

An Afghan national who fought alongside U.S. forces died from an allergic reaction while in the custody of Immigration and Customs Enforcement, one day after he was detained for deportation proceedings, his death certificate shows.

Mohammad Nazeer Paktiawal, 41, suffered “an adverse drug reaction” to an unidentified substance, which triggered anaphylaxis and exacerbated his asthma, according to the document. His March 14 death at a Dallas hospital was ruled to be an accident.

Paktiawal’s sudden death in ICE custody has drawn outrage because he had risked his life fighting as an ally of U.S. Special Forces in Afghanistan for a decade. Members of Congress and an advocacy group, AfghanEvac, have demanded answers about what happened.

Out of more than 50 ICE detention deaths during President Donald Trump’s second term, Paktiawal’s is the first to be ruled an accident, according to tracking by The Associated Press. Most of the others have been blamed on natural causes or suicide.

On Monday, AfghanEvac called on Texas authorities to release his full autopsy report, which they have sought to withhold by arguing its disclosure would interfere with an ongoing criminal investigation into the death.

"This family has a right to know what happened. Why won’t they release the report?” said Shawn VanDiver, president of AfghanEvac. He called on authorities to explain what substance triggered the allergic reaction, how it got into his system and why the date of the injury on the death certificate was listed as the day before Paktiawal was taken into custody.

Paktiawal was evacuated with thousands of others from Afghanistan when U.S. troops pulled out in 2021. He entered the U.S. through a legal process and requested asylum to stay. That claim was pending when ICE arrested him at his home in Richardson, Texas, on March 13 as he was taking some of his six children to school.

ICE has defended its decision to target Paktiawal for deportation, noting he had been arrested on food stamp fraud and theft charges. He has not been convicted in either case.

A one-page ICE report on Paktiawal’s death said that he was screened at its Dallas field office and denied any medical conditions or allergies. Hours later, he began experiencing shortness of breath and chest pain in a holding room and was taken to Parkland Memorial Hospital.

The next morning, hospital staff noted swelling of his tongue while he was eating breakfast and gave him epinephrine, a drug that treats allergic reactions, the report said. He was pronounced dead about 40 minutes later after life-saving measures were unsuccessful.

The certificate lists the cause of death as “anaphylaxis complicating acute asthma exacerbation.” Anaphylaxis is a severe allergic reaction typically triggered by food, drugs or insect venom. The document lists the toxic effects of methamphetamine, heart disease and cigarette smoking as contributing factors in the death.

His family members and coworkers said they did not know Paktiawal to use meth, and a private autopsy performed for the family could not confirm whether he had meth in his system because no blood remained for testing, VanDiver said. His wife has said that he relied on an inhaler for asthma, but ICE agents rejected her attempt to give them the device when he was taken into custody.

The cause and manner of death were established by the Dallas County Medical Examiner’s Office, where a doctor performed an autopsy on Paktiawal.