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Women at an ICE facility in Georgia accused a doctor of performing unwanted hysterectomies on them. Lawyers say the problems run even deeper.

Business Insider India logoBusiness Insider India 18-09-2020 Haven Orecchio-Egresitz
a group of people holding a sign: Women at an ICE facility in Georgia accused a doctor of performing unwanted hysterectomies on them. Lawyers say the problems run even deeper. © AP Photo/Jeff Amy, File Women at an ICE facility in Georgia accused a doctor of performing unwanted hysterectomies on them. Lawyers say the problems run even deeper.
  • A whistleblower complaint released this week accused Georgia OB-GYN Mahendra Amin of performing unwanted hysterectomies on immigrant women held at the Irwin County Detention Center in Georgia.
  • Dr. Amin's attorney told Insider that his client denied any wrongdoing alleged in the complaint and was confident his name would be cleared after an investigation.
  • Immigration attorneys who have represented people detained at Irwin told Insider that issues at the facility run deeper than the Project South complaint that grabbed national attention.
  • Attempts to reach LaSalle, the for-profit company that runs Irwin, were unsuccessful. Tony H. Pham, the director of Immigration and Customs Enforcement, called for a quick and thorough investigation into the whistleblower complaint, saying the concerns were "very serious."

Just under 10,000 people live in the sleepy county of Irwin, Georgia. Until recently, the county, and its county seat Ocilla, was best known for hosting the annual Georgia Sweet Potato Festival. But last week, a stunning whistleblower complaint from a nurse at a Georgia immigration detention center suddenly put Irwin County under scrutiny.

In a complaint that's ignited a furor among advocates, Congress, and the public, nonprofit group Project South and the nurse, Dawn Wooten, allege that women being held at by Immigration and Customs Enforcement at the Irwin County Detention Center were subjected to hysterectomies and procedures they didn't consent to or understand.

While Project South didn't identify the doctor responsible, lawyers for women who had previously raised concerns told Insider, NBC, and other news outlets that it was Dr. Mahendra Amin, an obstetrician-gynecologist and businessman with practices in southern Georgia.

"Everybody he sees has a hysterectomy — just about everybody," Wooten said in the report. "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."

Through his attorney, Scott Grubman, Amin denied any wrongdoing and said he was confident that his name would be cleared after an investigation.

"Dr. Amin is a highly respected physician who has dedicated his adult life to treating a high-risk, underserved population in rural Georgia," Dr. Amin told Insider in an email.

But local immigration attorneys who have worked with many of the women at the facility told Insider that the issues at Irwin run deeper than the headline-grabbing hysterectomy allegations.

The doctor identified in the complaint settled a false-claims investigation in 2015

a group of people standing in a fenced in area © REUTERS/Reade Levinson

There are no disciplinary actions noted on Amin's medical license, but this whistleblower complaint isn't the first time his reputation has been scrutinized.

Amin, who runs two practices in Douglas and Ocilla, also runs a company that had entered into a management agreement with the local hospital.

In 2013, he and several other doctors tied to the Irwin County Hospital, and the hospital itself, were the focus of a whistleblower civil case prosecuted by the Department of Justice and the state of Georgia. It accused them of defrauding the Medicaid and Medicare programs by submitting false claims.

Investigators alleged that Amin had required that "certain tests always be run on pregnant patients, without any medical evaluation and regardless of her condition," The Associated Press reported.

The 2015 settlement agreement, which Insider viewed, said the hospital, Amin, and eight other doctors promised to repay $520,000 to the government-funded programs. The doctors retained their medical licenses in Georgia, and Amin continues to accept patients on Medicare and Medicaid.

Grubman, who also represented Amin in the civil suit, told Insider that the settlement was reached "without any admission of liability."

"None of the allegations contained in the 2013 complaint were adjudicated in court, and the case was ultimately dismissed," he told Insider. And while Amin agreed to repay the money owed to the government, his lawyer stressed that he was not "required to pay any fine in connection with that settlement."

When asked how Amin was contracted years later to treat federal detainees, a spokeswoman for Immigration and Customs Enforcement told Insider that "the doctor" wasn't an ICE employee but rather an outside referral.

"Outside specialists are chosen by the facility from among the local community providers willing to accept ICE detainees as patients," the spokeswoman said in an emailed statement. "In some cases, the facility provider or clinical director may have community contacts they routinely work with."

The Irwin County Detention Center sits not far off of State Highway 11, its buildings surrounded by high fences and topped with barbed wire. Its been used as an ICE facility since 2010, and while its maximum capacity is 1201, it typically houses half that at any given time.

The facility is run by a for-profit company called LaSalle Corrections, which manages 18 facilities across Louisiana, Texas, and Georgia. Several attempts to reach Scott Sutterfield, a LaSalle executive whom staff directed questions to, were unsuccessful.

The Georgia Composite Medical Board also didn't return an email from Insider seeking comment.

A local immigration lawyer who's represented women at the facility says they alleged negative experiences with the doctor

a group of people standing in front of a sign © Joshua Roberts/Reuters

A Georgia attorney who has represented clients detained at Irwin told Insider that when Wooten's whistleblower complaint went public, she felt a wave of relief.

"I totally believed them with every fiber of my being and felt relieved," she said. The lawyer, whose identity is known to Insider, requested anonymity for fear of legal repercussions.

Over two weeks in 2018, the attorney told Insider, she received several complaints from clients about Amin.

The lawyer said the women talked generally about negative experiences during their visits, indicating that the doctor was too rough or impersonal and that they didn't want to be treated by him again.

As an immigration attorney, the lawyer said she doesn't typically have a role to play in these kinds of complaints — but she grew concerned when a client's gynecological illness became serious.

The woman had recently had a miscarriage while in custody, and in the months that followed she continued to have gynecological complications, the lawyer told Insider. She visited Amin about her condition for more than six months, but there was no improvement or treatment, she told the lawyer.

The lawyer said she went to a facility director to explain the situation and urged them to take the woman to a different doctor. When they did, the client was prescribed antibiotics for an underlying infection and soon recovered, the lawyer told Insider.

The lawyer alleged there was a clear "modus operandi" where detainees would go to the doctor for a gynecological visit and be diagnosed with issues, like ovarian cysts or heavy menstrual bleeding, that required follow-up visits.

"Maybe it's a money scheme, but people have been telling the facility that this doctor had been hurting them for at least two years," the lawyer told Insider. "If the government tries to say they didn't know about this, they're lying."

On Friday, the AP published an investigative report detailing the medical records of four women detained at Irwin. The AP said that while it wasn't able to confirm allegations of mass hysterectomies, detainees — or their attorneys — described being confused about gynecological procedures that Amin had performed on them.

Mileidy Cardentey Fernandez, a 39-year-old from Cuba, told the AP that she underwent an operation to treat ovarian cysts a month ago but wasn't sure what procedure she got. After requesting her medical documents multiple times, she received more than 100 pages, but none from the day of the surgery, the AP reported.

An attorney for another woman, Pauline Binam, of Cameroon, told the AP that Binam had gone to Amin for an irregular menstrual cycle. Binam was told she would be having a "D&C," or a dilation and curettage, to remove a part of the lining in the uterus — but when she woke up, she learned Amin had removed one of her two fallopian tubes, her attorney, Van Huynh, told the AP.

"She was shocked and sort of confronted him on that — that she hadn't given her consent for him to proceed with that," Huynh told the AP. "The reply that he gave was they were in there anyway and found there was this problem."

Project South has been investigating the Irwin County facility for years

a cake made to look like a car © REUTERS/Bing Guan

Insider hasn't independently verified accounts of unwanted hysterectomies at the Irwin detention center.

Project South, on Wooten's behalf, denied Insider's request to interview the nurse.

At a press conference this week, Wooten read a statement but didn't take questions about specifics of the hysterectomy allegations.

On Thursday evening, Azadeh N. Shahshahani, the legal and advocacy director at Project South, told Insider that in 2017 the organization produced a report on conditions at Irwin and the Stewart Detention Center, also in Georgia, alleging poor medical care and mistreatment at the facility.

Since then, she said, Project South has stayed in touch with some of the people at the facility and kept an eye on the situation.

"Over the years, we kept visiting. We kept talking to the people detained there," she said. "During the pandemic, the concerns were definitely raised to a new high level."

Shahshahani said Project South learned of a lack of COVID-19 testing and proper safety protocols.

This summer, the group was put in touch with Wooten, who was outraged over the lack of COVID-19 safety protocols and the medical care at the facility. She shared reports of what she believes are improper gynecological visits and a high rate of hysterectomies with Project South.

Shahshahani said the group knew it needed to act urgently on the allegation, demanding an independent investigation.

Project South said it had been able to talk to detainees who described unusually high rates of hysterectomies among other women being held at the facility — one of them said she knew five women who had the procedure. Wooten, too, described a high number of surgeries.

"We've questioned among ourselves, like, 'goodness he's taking everybody's stuff out ... That's his specialty, he's the uterus collector,'" Wooten told Project South, according to the complaint. "I know that's ugly ... is he collecting these things or something?"

The complaint said Project South spoke directly to one detainee who told them that she was scheduled for a hysterectomy and didn't understand why, but that it was canceled because of a positive COVID-19 antibody test. She expressed confusion about gynecological treatments ordered by the doctor that she thought were unnecessary.

Shahshahani admitted that some of the complaints made by the women had not been fully corroborated by Project South, and that the organization had connected with some women by phone or letter, while other reports were secondhand.

"The timing has been extremely short, so, you know, we have not had the chance to go dig in, as far as documents, as we normally may have, because we wanted to get this out as soon as possible," she told Insider.

a man that is standing in the street © Gregory Bull, File via AP

Some question the hysterectomy allegations. Others point to a lack of understanding stemming from a language barrier.

Some people who have worked with detainees at Irwin have questioned some of the allegations in the Project South complaint.

Paul Alvarado, a local immigration attorney, told Insider that he was "very, very skeptical" about the allegations of unwanted hysterectomies. Alvarado estimated that he'd been to Irwin representing clients more than 100 times.

"I've never heard of any sort of medical mistreatment from the clients, and I've represented hundreds of clients from Irwin, so it came as a shock to me when I read it," he said.

He said that while clients might complain about delays and other issues inherent to the immigration system, he hadn't been made aware of OB-GYN concerns.

"I've been an immigration lawyer for 24 years. I'm a huge proponent of immigration reform," he said. "I'm an advocate for the rights of these undocumented aliens, and I'd be the first to get to the podium and scream if something smelled fishy — but I have not heard of any of this."

Others said they thought the report lines up with a history of concerns raised at Irwin.

An attorney for the Southern Poverty Law Center, which has several lawyers dedicated to Irwin cases, told Insider the allegations were on track with the medical care at the facility, which she called "abhorrent."

The attorney, Lorilei Williams, said the SPLC had represented several clients detained at Irwin who were not given access to medical care, including at least one with a life-threatening condition who went weeks without medication.

The SPLC is looking into the cases of women it served who had come in contact with Amin for gynecological care.

"Generally speaking, across the board we've seen the detention centers fail to address medical needs," Williams said.

The lawyer who represented women seen by Amin in 2018 said there was a shortage of doctors in the region where Irwin is. She also said a lack of interpreters speaking detainees' native languages likely played a role in the lack of proper medical care.

She said that for the two years she worked out of Irwin full time, there was only one facility employee who was fluent in Spanish. Employees would sometimes use phone translation services or apps to communicate, but often they wouldn't make the effort, she told Insider.

Multiple reports have found over the years that many immigrants from Central America in federal custody speak Indigenous languages that the US government doesn't always have interpreters for.

LaSalle's website outlines its standards for healthcare at its facilities: "We employ and contract with experienced physicians, nurses, and other medical professionals to provide care tailored for inmates. Our staff understands the importance of maintaining proper documentation of medical records that is critical for effective treatments. Constant and clear communication with inmates and amongst the staff are essential for an efficient healthcare delivery system."

The immigration lawyer and Project South are hoping for real, lasting change at Irwin

a group of people standing in front of a fence © AP Photo/Jeff Amy

The lawyer said that while she long been concerned about the treatment of women at the facility, she felt as if her concerns "as an outsider looking in" were brushed off. Wooten, being on the inside, might have more of a chance to bring change, she said.

"I'm worried and concerned that this [complaint] is just going to be a trend and the government is going to be able to pass the buck and escape culpability," she said. "I want to see real systemic change."

Shahshahani, too, said she wanted the attention generated by Project South's complaint to bring real and lasting change.

Project South had previously sent several letters demanding change, but this one alleging mass hysterectomies has made bigger waves.

On Friday, ICE's director, Tony H. Pham, called for a quick and thorough investigations into the whistleblower complaint, saying the concerns were "very serious."

"ICE welcomes the efforts of both the Office of Inspector General as well as the Department of Homeland Security's parallel review," Pham said. "As a former prosecutor, individuals found to have violated our policies and procedures should be held accountable. If there is any truth to these allegations, it is my commitment to make the corrections necessary to ensure we continue to prioritize the health, welfare and safety of ICE detainees."

Wooten's complaint and Project South's statements have caused outrage among not only the public but Democratic lawmakers including House Speaker Nancy Pelosi and Senate Minority Leader Chuck Schumer. The House's immigration subcommittee is investigating the complaint.

Shahshahani told Insider that she wanted to see the facility closed, because its issues are built into its operating structure.

And while the allegations of reproductive-health abuses are "outrageous" and need to be stopped, Shahshahani said, other issues involving a lack of COVID-19 testing and care or delayed medications also deserve attention.

"We're talking about a whole system of human-rights violations against a detained population. That's why we're calling for this facility to be shut down," she said. "We don't believe that things are going to change if you get rid of one doctor or have a superficial change in the medical staff."

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