The death of a toddler is renewing concerns about the quality of medical care that immigrant families receive in federal detention centers.
18 month-old Mariee Juárez died after being detained along with her mother, Yazmin Juárez, at the South Texas Family Residential Center in Dilley, Texas. Her mother says Mariee was a happy, healthy child when they arrived at the U.S. border in March to seek asylum.
Then they were sent to Dilley. Six weeks after being discharged, her mother says, Mariee died of a treatable respiratory infection that began during her detention.
"The conditions at Dilley were unsanitary, unsafe and inappropriate for any small child," said R. Stanton Jones, a lawyer at the firm Arnold & Porter, which is representing Yazmin Juárez.
When Juárez raised concerns about her daughter's deteriorating condition, he alleges, she wasn't taken seriously. "The medical care that Mariee received in Dilley was neglectful and substandard," Jones said.
Doctors and immigrant advocates have long complained about the medical care at family detention centers overseen by U.S. Immigration and Customs Enforcement, or ICE. Dilley is the largest of three such facilities, with 2400 beds.
Those concerns have taken on new urgency as the Trump administration looks to detain more migrant families. In June, ICE requested space to accommodate 15,000 additional beds.
ICE declined to comment on the details of Mariee's case, which was first reported by VICE News. But the agency says it takes the welfare of immigrants in its care seriously.
"ICE is committed to ensuring the welfare of all those in the agency's custody, including providing access to necessary and appropriate medical care," ICE said in an emailed statement. "Staffing includes registered nurses and licensed practical nurses, licensed mental health providers, mid-level providers that include a physician's assistant and nurse practitioner, a physician, dental care, and access to 24-hour emergency care."
But a pediatrician who reviewed Mariee's medical records says she did not receive adequate care in Dilley.
"Nobody at any time decided to actually have a pediatrician or a doctor see the child," said Benard Dreyer, the director of pediatrics at the Bellevue Hospital Center in New York, and a past president of the American Academy of Pediatrics.
Dreyer reviewed Mariee's medical records from her time at Dilley at the request of her mother's lawyers, and says that nurses and physician assistants overlooked several high fevers, and other signs that Mariee's respiratory infection was getting worse.
"Can we guarantee that if [she] had been sent to the hospital a week earlier, it wouldn't have been too late? I can't guarantee that," Dreyer said. But he adds, "the child was very sick and should have been sent to a hospital."
Instead, Yazmin Juárez's lawyers say, Mariee was simply discharged from Dilley without ever seeing a doctor. Juárez and her daughter were driven to the airport in San Antonio. They flew to New Jersey, where Juárez took Mariee to the emergency room.
Mariee spent the last weeks of her life in hospitals. She died on May 10th of respiratory failure.
Her mother's lawyers signaled on Tuesday that they intend to sue. They're seeking seeking $40 million in damages for Mariee's "wrongful death" from the city of Eloy, Arizona. (Eloy is official contractor for Dilley under an unusual arrangement with the Department of Homeland Security and CoreCivic, the private prison company that operates the facility).
More lawsuits are expected to follow.
Doctors and immigrant rights advocates who are familiar with medical care in Dilley and other family detention centers say they're not surprised by Mariee's death.
In July, two doctors contracted by the Department of Homeland Security released a scathing assessment of care at those facilities. Scott Allen and Pamela McPherson conducted 10 investigations of family detention centers over the past four years, and found widespread problems with inadequate staffing and poor training.
"The threats to health and safety of the children are not merely theoretical," Allen and McPherson wrote. Family detention is "an exploitation and an assault on the dignity and health of children and families."