Letter to Hon. Alejandro Mayorkas, Secretary of Homeland Security - Homeland Security & Oversight Committees Release Update on Georgia ICE Facility Investigation, Inquire on DHS Action to Protect Migrants

Statement

Dear Secretary Mayorkas:

The treatment of migrants in Immigration and Customs Enforcement (ICE) detention,
particularly medical care provided to those in custody, has been a longstanding concern of the
Committee on Homeland Security and the Committee on Oversight and Reform. In conducting
oversight of this critical issue, the Committees have uncovered troubling information regarding
medical treatment provided by Dr. Mahendra Amin to female detainees in ICE custody at the
Irwin County Detention Center (ICDC). We write to share this information with you, to demand
that Dr. Amin never treat anyone in ICE custody again, and to request a briefing on the steps the
Department of Homeland Security (DHS) is taking to ensure that migrants receive appropriate
medical care while in the Department's custody.

Unfortunately, issues related to the quality of care at ICE detention facilities are
longstanding. In September 2020, the Committee on Homeland Security published several
findings in its Majority Staff Report entitled "ICE Detention Facilities: Failing to Meet Basic
Standards of Care." The Report highlighted concerning issues uncovered during staff visits to
facilities, including deficiencies in the medical, dental, and mental health care available to
migrants held in ICE detention.

Also in September 2020, the Oversight Committee released a Majority Staff Report
entitled "The Trump Administration's Mistreatment of Detained Immigrants: Deaths and
Deficient Medical Care by For-Profit Detention Contractors." This report highlighted troubling
findings from Oversight Committee staff inspections at ICDC and other DHS facilities, including
several serious health and safety issues at ICDC that the Committee referred to the DHS
Inspector General for further investigation.

Just days before the release of these reports, allegations surfaced that several women held
at ICDC, operated by LaSalle Corrections (LaSalle), had hysterectomies and other surgical
procedures performed on them by Dr. Amin without their consent. In light of these troubling
allegations, the Committees sent joint requests for records to ICE and LaSalle to assess the
gynecological care received by women held at ICDC. After LaSalle refused to produce these
documents voluntarily, the Committee on Homeland Security issued a subpoena to compel
production.

Medical records produced by LaSalle were reviewed by Dr. Tony Ogburn, Professor and
Chair of the University of Texas Rio Grande Valley School of Medicine's Department of
Obstetrics and Gynecology. Although Dr. Ogburn could not conclude whether patients received
unwanted hysterectomies, he found that Dr. Amin did not meet acceptable standards of care.
These concerns were so serious that Dr. Ogburn submitted a letter of complaint regarding Dr.
Amin to the Georgia Composite Medical Board (enclosed). Troublingly, Dr. Ogburn found that
Dr. Amin "was not up to date with current evidence-based guidelines," engaged in a "pattern of
performing the same surgery - D&C, laparoscopy (LSC) - on many patients no matter what their
condition was," and performed evaluation and treatment that "did not address [the patient's]
primary issue" but "instead he did a variety of tests and surgery that did them little or no good,
and potentially caused harm."

Dr. Ogburn concluded:

[Dr. Amin] was not competent and simply did the same evaluation
and treatment on most patients because that is what he knew how
to do, and/or he did tests and treatments that generated a significant
amount of reimbursement without benefiting most patients.

We applaud your decision to discontinue the immigrant detention contract with ICDC
and welcome your May 20, 2021, directive to review and enforce health and safety standards at
DHS detention facilities. We also appreciate DHS's recent production of documents that the
Committees first requested in September 2020. However, serious questions remain. For
example, we are concerned that Dr. Amin may have been performing unnecessary surgical
procedures to defraud DHS and the Federal government without consequences. We are also
concerned that people at other detention facilities may be receiving similarly inappropriate or
inadequate medical treatment. DHS has thus far identified only two detention facilities as unsuitable for housing ICE detainees after more than six months of review, even though the Committees' investigations have identified serious concerns about many others.

Accordingly, we ask you to provide the Committees with a briefing by December 16,
2021 to answer the questions below.

First, has DHS reviewed treatment provided by Dr. Amin to women in ICE custody? If
so, what is the status and outcome of that review?

Second, has DHS made any referrals to law enforcement or the Department of Justice
related to the conduct of Dr. Amin? Is DHS aware of any such investigations by criminal or civil
authorities?

Third, what steps is DHS taking to ensure that migrants held in ICE custody receive
proper medical care? What steps is DHS taking to ensure that other doctors are not providing
substandard care or engaging in unethical practices when treating migrants in ICE custody?

Finally, the Committee on Homeland Security requested a briefing on August 10, 2021,
on DHS's efforts to review the suitability of detention facilities. To date, DHS has not fulfilled
this request. We ask that you ensure the Committees receive this briefing without further delay.

Thank you for your prompt attention to this matter.

Sincerely,