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Characteristics of Deaths Among Individuals in US Immigration and Customs Enforcement Detention Facilities, 2011-2018

IMPORTANCE: Concerns have been raised that substandard medical care has contributed to deaths in US Immigration and Customs Enforcement (ICE) detention facilities. After each in-custody death, ICE produces detainee death reviews, which describe the circumstances of the death and determine whether IC...

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Autores principales: Grassini, Molly, Terp, Sophie, Fischer, Briah, Ahmed, Sameer, Ross, Madeline, Frenzen, Niels, Burner, Elizabeth, Parmar, Parveen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Medical Association 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8264644/
https://www.ncbi.nlm.nih.gov/pubmed/34232301
http://dx.doi.org/10.1001/jamanetworkopen.2021.16019
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author Grassini, Molly
Terp, Sophie
Fischer, Briah
Ahmed, Sameer
Ross, Madeline
Frenzen, Niels
Burner, Elizabeth
Parmar, Parveen
author_facet Grassini, Molly
Terp, Sophie
Fischer, Briah
Ahmed, Sameer
Ross, Madeline
Frenzen, Niels
Burner, Elizabeth
Parmar, Parveen
author_sort Grassini, Molly
collection PubMed
description IMPORTANCE: Concerns have been raised that substandard medical care has contributed to deaths in US Immigration and Customs Enforcement (ICE) detention facilities. After each in-custody death, ICE produces detainee death reviews, which describe the circumstances of the death and determine whether ICE Performance-Based National Detention Standards (PBNDS) were violated. OBJECTIVE: To describe factors associated with deaths in ICE detention facilities. DESIGN, SETTING, AND PARTICIPANTS: This case series used data extracted from detainee death reviews of deaths among individuals detained in ICE facilities for whom these reviews were available from January 2011 to December 2018. EXPOSURES: All individuals were in the custody of ICE at the time of death. MAIN OUTCOMES AND MEASURES: Data including demographic information, medical histories, recorded medical data, and reported violations of PBNDS were systematically extracted and summarized. RESULTS: Among 71 individuals who died in an ICE detention facility during the study period, detainee death reviews were available for 55 (77.5%). Most were male (47 [85.5%]), and the mean (SD) age at death was 42.7 (11.5) years. Individuals resided in the US for a mean (SD) of 15.8 (13.2) years before detention and were in ICE custody for a median of 39 days (interquartile range, 9-76 days) before death. Most had low burdens of preexisting disease, with 18 (32.7%) having a Charlson Comorbidity Index score of 0 and 15 (27.3%) having a score of 1 or 2. A total of 47 deaths (85.5%) were attributed to medical causes and 8 (14.5%) to suicide. Markedly abnormal vital signs were documented in the death reviews before 29 of 47 deaths from medical causes (61.7%), and 21 of these 29 deaths (72.4%) were preceded by abnormal vital signs during 2 or more encounters with ICE personnel before death or terminal hospital transfer. Overall, 43 detainee death reviews (78.2%) identified PBNDS violations related to medical care, with a mean (SD) of 3.2 (3.0) deficiencies per detainee death review. CONCLUSIONS AND RELEVANCE: In this case series, deaths in ICE detention facilities from 2011 to 2018 occurred primarily among young men with low burdens of preexisting disease. Markedly abnormal vital signs preceded death or hospital transfer for most nonsuicide deaths. The PBNDS were violated in most detainee death reviews. These results suggest that additional oversight and external evaluation of practices related to medical and psychiatric care within ICE facilities are needed.
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spelling pubmed-82646442021-07-09 Characteristics of Deaths Among Individuals in US Immigration and Customs Enforcement Detention Facilities, 2011-2018 Grassini, Molly Terp, Sophie Fischer, Briah Ahmed, Sameer Ross, Madeline Frenzen, Niels Burner, Elizabeth Parmar, Parveen JAMA Netw Open Original Investigation IMPORTANCE: Concerns have been raised that substandard medical care has contributed to deaths in US Immigration and Customs Enforcement (ICE) detention facilities. After each in-custody death, ICE produces detainee death reviews, which describe the circumstances of the death and determine whether ICE Performance-Based National Detention Standards (PBNDS) were violated. OBJECTIVE: To describe factors associated with deaths in ICE detention facilities. DESIGN, SETTING, AND PARTICIPANTS: This case series used data extracted from detainee death reviews of deaths among individuals detained in ICE facilities for whom these reviews were available from January 2011 to December 2018. EXPOSURES: All individuals were in the custody of ICE at the time of death. MAIN OUTCOMES AND MEASURES: Data including demographic information, medical histories, recorded medical data, and reported violations of PBNDS were systematically extracted and summarized. RESULTS: Among 71 individuals who died in an ICE detention facility during the study period, detainee death reviews were available for 55 (77.5%). Most were male (47 [85.5%]), and the mean (SD) age at death was 42.7 (11.5) years. Individuals resided in the US for a mean (SD) of 15.8 (13.2) years before detention and were in ICE custody for a median of 39 days (interquartile range, 9-76 days) before death. Most had low burdens of preexisting disease, with 18 (32.7%) having a Charlson Comorbidity Index score of 0 and 15 (27.3%) having a score of 1 or 2. A total of 47 deaths (85.5%) were attributed to medical causes and 8 (14.5%) to suicide. Markedly abnormal vital signs were documented in the death reviews before 29 of 47 deaths from medical causes (61.7%), and 21 of these 29 deaths (72.4%) were preceded by abnormal vital signs during 2 or more encounters with ICE personnel before death or terminal hospital transfer. Overall, 43 detainee death reviews (78.2%) identified PBNDS violations related to medical care, with a mean (SD) of 3.2 (3.0) deficiencies per detainee death review. CONCLUSIONS AND RELEVANCE: In this case series, deaths in ICE detention facilities from 2011 to 2018 occurred primarily among young men with low burdens of preexisting disease. Markedly abnormal vital signs preceded death or hospital transfer for most nonsuicide deaths. The PBNDS were violated in most detainee death reviews. These results suggest that additional oversight and external evaluation of practices related to medical and psychiatric care within ICE facilities are needed. American Medical Association 2021-07-07 /pmc/articles/PMC8264644/ /pubmed/34232301 http://dx.doi.org/10.1001/jamanetworkopen.2021.16019 Text en Copyright 2021 Grassini M et al. JAMA Network Open. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the CC-BY License.
spellingShingle Original Investigation
Grassini, Molly
Terp, Sophie
Fischer, Briah
Ahmed, Sameer
Ross, Madeline
Frenzen, Niels
Burner, Elizabeth
Parmar, Parveen
Characteristics of Deaths Among Individuals in US Immigration and Customs Enforcement Detention Facilities, 2011-2018
title Characteristics of Deaths Among Individuals in US Immigration and Customs Enforcement Detention Facilities, 2011-2018
title_full Characteristics of Deaths Among Individuals in US Immigration and Customs Enforcement Detention Facilities, 2011-2018
title_fullStr Characteristics of Deaths Among Individuals in US Immigration and Customs Enforcement Detention Facilities, 2011-2018
title_full_unstemmed Characteristics of Deaths Among Individuals in US Immigration and Customs Enforcement Detention Facilities, 2011-2018
title_short Characteristics of Deaths Among Individuals in US Immigration and Customs Enforcement Detention Facilities, 2011-2018
title_sort characteristics of deaths among individuals in us immigration and customs enforcement detention facilities, 2011-2018
topic Original Investigation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8264644/
https://www.ncbi.nlm.nih.gov/pubmed/34232301
http://dx.doi.org/10.1001/jamanetworkopen.2021.16019
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