Senate panel: Detained immigrants in Ga. endured invasive OB-GYN care

An 18-month investigation alleges “aggressive and unethical” care of a doctor treating immigrant women.

A former immigrant detainee told a U.S. Senate panel Tuesday that she “went through hell” during her time at a South Georgia immigrant jail, fighting tears as she recounted how she unwittingly received a contraceptive injection during an OB-GYN check-up while locked up.

The former detainee joined experts in outlining abuse allegedly suffered by immigrants at the Irwin County Detention Center (ICDC) in testimony before the U.S. Senate Permanent Subcommittee on Investigations. The panel, chaired by Sen. Jon Ossoff of Georgia, also issued a sobering report on the medical mistreatment of women held in U.S. Immigration and Customs Enforcement (ICE) custody in Irwin County, spotlighting the “aggressive and unethical” care of a local gynecologist.

The result of an 18-month-long bipartisan investigation, the 103-page report details a pattern of “excessive, invasive, and often unnecessary” gynecological procedures. It also raises questions about detainees’ ability to consent to the procedures and describes gaps in ICE oversight that could have been a factor in the alleged medical abuse.

According to the report, six women interviewed by the subcommittee said their gynecological care during their time at the privately-run ICDC left them “confused, afraid and violated.” Several reported that they still live with physical pain and worry that the treatments they received may have compromised their fertility.

Credit: Nathan Posner for the Atlanta Journal Constitution

Credit: Nathan Posner for the Atlanta Journal Constitution

“In my view, [this] represents a catastrophic failure by the federal government to respect basic human rights,” Ossoff said as the hearing began. “Among the serious abuses this subcommittee has investigated during the last two years, subjecting female detainees to nonconsensual and unnecessary gynecological surgeries is one of the most nightmarish and disgraceful.”

The treatment of women in ICE detention in Georgia received national attention in the fall of 2020, when a whistleblower alleged that an off-site doctor had performed mass hysterectomies on ICDC detainees. The provider in question was later identified as Dr. Mahendra Amin, an OB-GYN who had treated ICDC detainees since 2014.

Senate investigators found that Amin performed just two hysterectomies on ICDC detainees between 2017 and 2019, with both procedures considered medically necessary by ICE. But analysis of ICE data revealed Amin accounted for a disproportionately high number of invasive gynecological procedures performed on detained migrant women nationwide, making him a “clear outlier,” according to the report.

From 2017 to 2020, ICDC housed only about 4% of female ICE detainees nationwide, and Amin accounted for roughly 6.5% of total OB-GYN visits among all ICE detainees in that period. But he was found to be behind more than 90% of some key gynecological procedures performed nationwide, as well as almost one-third of all such procedures performed for ICE.

  • From 2017 to 2020, Amin performed 53 dilation and curettage (“D&C”) procedures, or 82% of all such procedures on ICE detainees. In that same span, the next most prolific physician accounted for three such procedures. A D&C procedure removes tissue from inside the uterus with the help of a spoon-shaped instrument or suction device.
  • From 2017 to 2020, Amin performed 44 laparoscopies to excise lesions, or 94% of all such procedures conducted on all ICE detainees. Laparoscopies are generally performed under anesthesia.
  • From 2017 to 2020, Amin administered 102 Depo-Provera injections, or 93% of all such injections by all OB-GYN specialists to ICE detainees. The injection is generally administered every three months to prevent pregnancy or manage menstrual cycle issues.

Senators said the high number of procedures raised the specter of an overbilling scheme.

“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,” Amin’s attorney, Scott Grubman, said in an email. The Senate subcommittee “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 [subcommittee] was not at all interested in the truth, but simply scoring political points.”

Senate investigators interviewed more than 70 witnesses and reviewed more than 540,000 pages of records from ICE, ICDC, the U.S. Department of Homeland Security and Irwin County Hospital, where Amin performed the procedures.

According to medical experts who reviewed some of those records for the panel, there was a lack of informed consent in many instances from ICDC patients seen by Amin.

“It’s very disturbing,” Dr. Stewart Smith, assistant director of ICE’s Health Service Corps, testified Tuesday. “Any responsibility that we have, we take very seriously. We want to fix the system so that it doesn’t happen again.”

In a statement, an ICE spokesperson told the AJC that the agency is “fully cooperating with all requests for information” from oversight bodies looking into allegations of medical abuse at ICDC.

Credit: Nathan Posner for the Atlanta Journal Constitution

Credit: Nathan Posner for the Atlanta Journal Constitution

Ossoff repeatedly admonished Smith for the allegedly scant vetting performed by ICE of off-site medical providers.

The panel’s report said a major U.S. insurance company dropped Amin as a covered physician in 2005 because of “excessive malpractice cases” and an “extensive malpractice history.” And in 2013, the U.S. Department of Justice and the state of Georgia filed a lawsuit against Amin and other physicians at Irwin County Hospital over allegations of Medicaid fraud, and performing unnecessary gynecological procedures. The lawsuit was settled two years later.

“Those should have been warnings signs to watch a little more closely,” Ossoff told Smith.

Amin stopped treating ICDC detainees in September 2020, when the allegations against him were first made public. Roughly a year later, ICE ended its contract with the detention center, to the distress of Irwin County officials. In December 2020, several detainees filed a class-action suit against Amin and ICE. That litigation is ongoing.

At the conclusion of Tuesday’s hearing, Ossoff condemned the mistreatment of immigrant detainees in Irwin County.

“This is such an appalling case,” he said. “I can’t think of anything worse than this. Unnecessary surgeries performed on prisoners? Give me a break. It’s an abject failure … It’s a disgrace to the federal government.”

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