Investigation finds women detained by ICE underwent "unnecessary gynecological procedures" at Georgia facility
Washington — A congressional investigation into medical abuse allegations that garnered national attention in 2020 found that some immigrant women held by U.S. immigration officials at a Georgia detention center likely underwent "unnecessary" invasive gynecological procedures, according to a report released Tuesday.
The 18-month bipartisan investigation by the Senate's Permanent Subcommittee on Investigations reviewed allegations that women detained by U.S. Immigration and Customs Enforcement (ICE) at the Irwin County Detention Center in Ocilla, Georgia had endured medical neglect, lax coronavirus mitigation policies and questionable procedures, including hysterectomies.
The allegations first surfaced in an explosive Sept. 2020 whistleblower complaint by Dawn Wooten, who worked as a nurse at the Ocilla detention facility.
The investigation's 108-page report was formally presented by Georgia Democratic Sen. Jon Ossoff, the chair of the subcommittee, later on Tuesday during a hearing. Officials from ICE, the Homeland Security Inspector General and LaSalle Corrections, the private company operating the Ocilla facility, testified following testimony from Wooten, as well as a former immigrant detainee and physicians.
Tuesday's report said investigators did not corroborate "allegations of mass hysterectomies." But investigators said they did find "serious issues" regarding medical procedures and policies at the Georgia facility and the conduct of Mahendra Amin, a doctor whom Irwin County detainees accused in 2020 of performing questionable medical procedures, including, in some cases, without the patients' full consent.
The Biden administration in May 2021 ordered ICE to stop holding immigrants at the Irwin County facility as part of an effort to reform immigration detention. CBS News reached out to representatives for Amin, ICE and LaSalle Corrections, which still runs the Ocilla facility under a contract with the U.S. Marshals Service.
Citing a medical review it commissioned of over 16,600 pages of medical records pertaining to 94 women treated by Amin, the congressional subcommittee concluded that "female detainees appear to have undergone excessive, invasive, and often unnecessary gynecological procedures."
Dr. Peter Cherouny, the obstetrician-gynecologist tasked with reviewing the women's medical records, said Amin's approach to surgical procedures was "too aggressive," investigators said. Cherouny found Amin's care to be antiquated, calling it "pretty good medicine for the 1980s, but we're not there anymore."
"Dr. Cherouny explained that 40 patient records — of the 94 examined — indicated the patients had benign ovarian cysts removed by Dr. Amin, despite the fact that benign ovarian cysts 'generally resolve without surgical intervention,'" the report said.
Cherouny, the report noted, said the risks associated with these surgeries include infection, bleeding, pain and even infertility.
The report said six formerly detained women told investigators that Amin was "rough and insensitive" during medical procedures and failed to be forthcoming about his diagnoses and treatment plans.
"These women described feeling confused, afraid, and violated after their treatment by Dr. Amin," investigators said. "Several reported that they still live with physical pain and uncertainty regarding the effect of his treatments on their fertility."
During the subcommittee hearing on Tuesday, Karina Cisneros Preciado said she "went through hell" while in detention at the Irwin County facility, describing unsanitary conditions. But she said the worst experience occurred after she asked for a postpartum medical check-up.
Cisneros Preciado said she was told she would get a Pap smear, a procedure to test for cervical cancer. But after being taken to the clinic in handcuffs, she said Amin did not explain the procedure she would undergo or even acknowledge her.
"Then he just says, 'open your legs' and continues with 'it's going to be cold' and inserts a white tube inside of me. He wiggles it around, roughly. It was extremely uncomfortable," Cisneros Preciado said. "As I'm about to look at the monitor that's next to me, he immediately pulls it out and tells me that I have cyst on my left ovary and that I'm going to get a Depo shot for it and if the cyst does not dissolve in four weeks, I'm going to have to come back for surgery."
Then, Cisneros Preciado added, Amin asked his nurse, "How many more?"
"The reason I'm telling this story is because this shouldn't happen to anyone anymore," Cisneros Preciado said. "We're not animals. We're human. We're not just a number."
The subcommittee called Amin "a clear outlier" in the number and types of gynecological procedures he performed on ICE detainees. "Ultimately, the Subcommittee's investigation found that Dr. Amin performed just two hysterectomies, one in 2017 and one in 2019, which ICE deemed to be medically necessary," the report said. "However, the Subcommittee did find that Dr. Amin performed an unusually high number of other gynecological procedures on ICDC detainees."
While the Irwin County detention center held 4% of women in ICE custody between 2017 and 2020, the report said, Amin performed over 80% of certain gynecological procedures on detainees across the U.S. during that time, including laparoscopies, Depo-Provera injections, limited pelvic exams and dilation and curettage procedures.
According to the report, investigators tried to interview Amin, but their requests for voluntary testimony were denied. After the subcommittee issued a subpoena for his testimony, Amin, through his lawyer, said he "declined to provide testimony pursuant to his Fifth Amendment privilege against self-incrimination."
In statement, Scott Grubman, a lawyer for Amin, accused the subcommittee of focusing on "scoring political points."
"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.
Investigators said Amin was under criminal investigation by the federal government as of earlier this year. A separate internal investigation by the U.S. Department of Homeland Security (DHS) and a federal lawsuit related to medical procedures for immigrants held at the Irwin County facility remain ongoing, the subcommittee said.
Tuesday's report found that ICE does not have a policy of securing immigrants' consent for medical procedures conducted outside of facilities overseen by the agency. ICE officials, the report said, "stated to the Subcommittee that it is the sole professional obligation of the off-site provider to obtain informed consent from patients."
The investigation also uncovered 659 reports from detainees who described "delayed or deficient medical care" at the Irwin County detention center between 2018 and 2020. Investigators said ICE and LaSalle Corrections, the private company that oversees the Georgia detention facility, "failed to take effective corrective action" to address the grievances.
Moreover, the report raised questions about ICE's vetting and oversight procedures for medical providers. The subcommittee said ICE was not aware of several malpractice claims against Amin and other physicians or a federal lawsuit against him before the Sept. 2020 whistleblower complaint.
Investigators noted that Amin was not board certified, and had been sued in 2013 by officials in Georgia and the Justice Department, who claimed he committed Medicaid fraud by "ordering unnecessary and excessive medical procedures." The case was settled in 2015, with Amin and his codefendants paying $520,000, but not admitting any wrongdoing, the report said.
In the hearing Tuesday, Stewart Smith, a top official in ICE's medical arm, said the agency treated the allegations regarding Amin and the Irwin County detention center "very seriously." He noted ICE ceased referring detainee patients to Amin's clinic and later stopped using the Irwin County facility all together.
ICE, Smith added, is "improving its oversight of off-site providers by establishing national care guidelines and instituting a utilization review process, an initiative started well before the allegations came to light."