Inspector warned of problems in immigration centers before the death of a girl

A court-appointed inspector said in January that migrant children in medical isolation in immigration detention centers could be overlooked when Border Patrol stations are too crowded, a warning issued five months before an 8-year-old girl with a heart condition died in custody during an unusually busy period in the same region of Texas that he surveyed.

Dr. Paul H. Wise, a professor of pediatrics at Stanford University, declared the death of Panamanian girl Anadith Tanay Reyes Álvarez “preventable” during an interview this week while he was in the Rio Grande Valley, Texas, for investigate the circumstances.

“When a child is sick, particularly those with chronic problems, there should be no hesitation in referring them to local hospitals, preferably a children’s hospital or one with good pediatric capabilities,” Wise told The Associated Press.

The United States Customs and Border Protection (CBP) acknowledged that medical personnel saw the girl at least three times the day she died — she complained of vomiting, stomach pain and suffered what appeared to be be a seizure—before she was taken to a hospital. CBP did not respond to a request for comment on Wise’s January report or her latest allegations.

Wise wrote a lengthy report in January on Border Patrol custody conditions for children in the Rio Grande Valley and El Paso, Texas, which provided satisfactory assessments on many counts but also flagged serious concerns. Last year, a federal judge asked him to examine custody conditions in the two regions as part of a 1997 court agreement to ensure safe treatment of migrant children.

Wise plans to file a report on the death of the girl soon on May 17, who died on her ninth day in custody after being taken to a station in Harlingen, Texas, with her family after being diagnosed with influenza. The agency limits custody to 72 hours, per its own policy.

While his findings are not yet known — Wise declined to comment — some of his earlier warnings may resurface.

Wise previously raised concerns about the overcrowding of children in medical isolation. His January report recounts how “a medical team” in El Paso was responsible for 125 sick patients, a number that “far exceeds” the team’s capabilities.

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Border Patrol also struggled to comply with the requirement to conduct periodic medical evaluations of children when they arrived as families and were at crowded stations, Wise said in January.

“Repeated medical evaluation every 5 days is most important when families are detained for long periods in crowded conditions,” he wrote. “However, due to other significant demands on available medical personnel, this medical protocol appears to be of relatively low priority under these conditions.”

Wise also expressed concern about chronic conditions going undetected and “relevant medical information” being unknown or not shared among staff.

CBP’s relatively detailed public account of the girl’s time in custody does not directly address the requirement for exams every five days or how full the Harlingen station was when she was there.

The government’s responsibilities for children’s health care are clearly defined in the recently updated agreement for the El Paso and Rio Grande Valley sectors. “CBP will immediately activate the 911 system or refer minors to the local health system when appropriate for evaluation and treatment. Additionally, CBP will refer minors with urgent or emergent medical issues to the local health system,” the agreement stipulates.

During his visit, Wise interviewed Anadith’s mother, Mabel Álvarez Benedicks, who told the AP that officers repeatedly ignored pleas to hospitalize her daughter because her bones were aching, breathing hard and she couldn’t walk.

Agents said her daughter’s flu diagnosis did not require hospital care, Benedicks said. They knew the girl had a history of heart problems, but she was told to come back if she fainted, her mother said.

Troy Miller, acting CBP commissioner, has since ordered a review of all detainees in frail health to ensure limited time in immigration custody. Wise said he spoke with federal officials, including medical personnel, to convey concerns about his recent visit.

“I have enough information at this time to make urgent recommendations to CBP (to the Department of Homeland Security) and to the court. And this will focus on the steps that need to be taken, in my opinion, to ensure that preventable deaths of children do not occur in CBP custody,” the inspector said.

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