A whistleblower complaint filed this week with the Department of Homeland Security’s Office of the Inspector General alleges that high rates of hysterectomies — sometimes without what the complaint called “proper informed consent” — have been performed on women detained in a privately owned immigration jail in Georgia.
The complaint, filed by the human rights group Project South, quoted a detainee from U.S. Immigration and Customs Enforcement’s Irwin County Detention Center saying that five women who had the procedure between October and December 2019 had told her that they “reacted confused when explaining why they had one done.” Multiple women claimed that they did not have access to proper interpreters and that medical staff often did not speak Spanish.
The accounts in Project South’s complaint — which included that of the whistleblower Dawn Wooten, a licensed practical nurse at the facility — were consistent with accounts given in separate interviews conducted by The Intercept with three other current detainees at the facility, eight advocates for detainees at the prison, and a former Irwin employee, all of whom requested anonymity for fear of reprisals against themselves and their clients.
“Everybody he sees has a hysterectomy — just about everybody,” Wooten, who is being represented as a whistleblower by Project South and the Government Accountability Project, explained in the complaint. “I’ve had several inmates tell me that they’ve been to see the doctor, and they’ve had hysterectomies, and they don’t know why they went or why they’re going.”
Like many other ICE detention centers, Irwin, which is operated by the private prison firm LaSalle Corrections, has come under fire for medical mistreatment. Wooten’s whistleblower complaint, which The Intercept reported on Monday, focused on precautions at Irwin related to the coronavirus pandemic. The accounts of the high rates of hysterectomies, which were first reported by the legal website Law and Crime, were also included in the Project South complaint to the Office of the Inspector General.
In a statement to The Intercept, ICE said it does not comment on matters presented to the Office of Inspector General. “ICE takes all allegations seriously and defers to the OIG regarding any potential investigation and/or results,” the ICE statement said. “That said, in general, anonymous, unproven allegations, made without any fact-checkable specifics, should be treated with the appropriate skepticism they deserve.” The agency maintains that the Irwin County Detention Center has been inspected multiple times, with and without warning, and that the facility has been found to be in compliance with Performance-Based National Detention Standards.
In a statement sent to news media and, reportedly, Congress made after publication of this story, an ICE official said, “According to U.S. Immigration and Customs Enforcement (ICE) data, since 2018, only two individuals at Irwin County Detention Center were referred to certified, credentialed medical professionals at gynecological and obstetrical health care facilities for hysterectomies in compliance with National Commission on Correctional Health Care (NCCHC) standards. Based on their evaluations, these specialists recommended hysterectomies. These recommendations were reviewed by the facility clinical authority and approved.”
LaSalle Corrections did not respond to a request for comment. The Department of Homeland Security’s Office of the Inspector General did not immediately respond to a request for comment.
On Tuesday, Speaker of the House Nancy Pelosi called for an investigation into Wooten’s allegations. Georgia State Rep. Bob Trammell sent a letter on Monday to the Georgia Composite Medical Board and the Georgia Board of Nursing after the complaint was published, requesting that they “immediately suspend the licenses of the providers named in the whistleblower complaint pending a full investigation by your offices.”
Though Wooten, in an interview with The Intercept on Monday, declined to identify the doctor, according to interviews with a detainee, two detainee advocates, and a former Irwin employee, the doctor is Mahendra Amin, an obstetrics and gynecology specialist based in Douglas, Georgia, near Irwin County Detention Center in Ocilla. Amin, who has operated through at least one other practice, also has a relationship with Irwin County Hospital, where the immigration detention facility takes some detainees for treatment. The doctor’s identity, which was first reported by Prism, did not appear in the whistleblower’s complaint to the Homeland Security Office of Inspector General.
When reached by phone for comment, Amin confirmed that he conducted procedures on immigrant women brought from the facility. He said that after he conducts exams, he requires the approval of the detention center before conducting any necessary procedures. Amin said that he has only performed “one or two hysterectomies in the past two [or] three years.” When pressed, he did not specify whether those hysterectomies were performed on people detained in Irwin.
Amin said that allegations of performing procedures without patients’ consent were ruining his reputation and affecting his practice. “Everything is wrong, and if you want to talk, talk to the hospital administrator,” Amin said, referring to Irwin County Hospital, and then hung up the phone.
In a statement made to the news media, a lawyer for Amin said the doctor “vigorously” denied the allegations. “Dr. Amin is a highly respected physician who has dedicated his adult life to treating a high-risk, underserved population in rural Georgia,” said Scott Grubman, the lawyer. “We look forward to all of the facts coming out and are confident that, once they do, Dr. Amin will be cleared of any wrongdoing.”
Reached by text message, Irwin County Hospital CEO Paige Wynn said consent was obtained for all surgical procedures. “We do not do any surgeries that do not have prior consent from ICE and the patients,” Wynn said. “We cannot specifically comment on any specific patient matter due to patient privacy obligations.” (Neither Wynn nor Amin responded immediately to a more specific, written requests for comment.)
“All I know is, if you go in for anything, the majority of the time, he’s going to suggest surgery. I don’t know why. I just — I don’t know why. He does a lot of surgeries.”
The former Irwin employee said that Amin is the only OB-GYN serving the detained population in Irwin. “All I know is, if you go in for anything, the majority of the time, he’s going to suggest surgery,” the former Irwin employee said. “I don’t know why. I just — I don’t know why. He does a lot of surgeries.”
Amin was previously taken to court for making false Medicaid claims. In a case filed against him, other doctors, and Irwin County Hospital in the U.S. District Court for the Middle District of Georgia, the government alleged that the hospital was billing Medicaid for obstetric ultrasounds, even if they weren’t necessary. The case was dismissed as part of a settlement, in which the hospital paid more than half a million dollars to the government, but did not admit any liability. The government, as part of the settlement, did not admit that its own claims were unfounded.
Several women detainees whose accounts of medical visits were shared with The Intercept said they had no choice but to go to the doctor, who has become notorious among detainees for “rough treatment” of women during gynecological exams and performing a high number of procedures. The accounts were consistent with the whistleblower complaint.
According to an advocate, one woman who had repeated medical visits requested deportation because she was worried that she would “lose her reproductive system” if her only choices were to see the doctor or remain untreated. The woman was subsequently deported.
The current detainees at Irwin who spoke with The Intercept said they were pressured by the doctor to undergo partial or full hysterectomies. One of the women estimated that as many as 20 others were recommended for an operation, in some cases undergoing surgery on the recommendations. All of the women who spoke to The Intercept said that no interpreter was present, and they were unclear about the necessity or purpose of the proposed treatment.
In an interview with The Intercept on Tuesday, Wooten estimated that more than 20 women had undergone hysterectomies in the last six years. “People ask you why I got a hysterectomy,” Wooten said. “I couldn’t explain it. The only thing I have to say is that I’m sorry.” Wooten described one 23-year-old woman who wasn’t told what the operation entailed until after the procedure. In the Project South complaint to the inspector general, Wooten called the doctor “the uterus collector.” She told the human rights group, “Everybody he sees, he’s taking all their uteruses out, or he’s taken their tubes out.”
One detainee told The Intercept that “the doctor got mad when I didn’t want to have the surgery” to remove a cyst. “No woman should go through this,” the detainee said, through tears. “There’s something strange going on.” Another woman who The Intercept spoke with said she simply didn’t understand why the doctor was insisting on an operation or even exactly what it would be. She had heard from other women that “he just empties you all out.”
According to one advocate who spoke to The Intercept on the condition of anonymity to shield a detainee from reprisals, a woman detained in Irwin saw the doctor for spotting, or light vaginal bleeding. The doctor claimed the woman had a cyst — a claim the woman was dubious about — and insisted on a procedure to remove uterine tissue. While performing the procedure, the doctor removed part of the woman’s fallopian tube, claiming that “it was clogged,” according to the advocate. The woman never gave her consent.
“Assuming the allegations are true, I question the decisions DHS and ICDC make regarding the medical care for detained migrants,” said Lorelei Williams, an attorney with the Southern Poverty Law Center’s Southeast Immigrant Freedom Initiative. She said it appears that officials at the ICE prison “fail to provide basic medical care, necessary lifesaving treatments, and the resources needed to protect detained migrants during the Covid-19 pandemic — why?”
Gregory Dober, an adjunct professor at Lake Erie College of Osteopathic Medicine and expert in health care ethics and law regarding incarcerated individuals, told The Intercept that “medical law and ethics doesn’t care about the inconvenience by having to perform two procedures.” He added that informed consent is a process, explaining that interpreters should be present. “The process, purpose of the procedure, risks, and benefits and alternative treatments should be discussed and noted,” Dober said.
“The allegations regarding high number of hysterectomies and lack of informed consent requires a full and trauma-informed investigation,” said Amanda Klasing of the Women’s Rights Division of Human Rights Watch, in a statement to The Intercept. “Human Rights Watch research has shown consistent neglect and abuse in the health services provided in immigration detention, including failure to communicate clearly to patients, which makes these allegations particularly disturbing.”
Update: September 18, 2020
This story has been updated to include a statement made to media after publication by a lawyer representing the doctor, as well as a statement from ICE to media made after publication claiming that two detainees at Irwin have were referred for hysterectomies since 2018, both in accordance with medical and institutional standards and policies.
Correction: September 18, 2020
Due to an editing error, an earlier version of this story said that, along with Irwin County Hospital, Amin and other doctors named as defendants in a court case over allegations of false claims to Medicaid and Medicare made payments to the government as part of a settlement. According to the settlement, as well as a subsequent statement by the hospital to the Associated Press, Irwin County Hospital alone, not the defendant doctors, were responsible for the payment as part of the settlement. The reference to the doctors making the payments has been removed from the story.