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ICE Deleted Reviews for Deaths in Custody That Cited Shoddy Medical Care

Three-quarters of ICE’s own 2025 death reviews, briefly posted online, raised substandard and “inappropriate” care of ill detainees.

Detention staff broke with safe standards of medical care for at least six detainees who died in U.S. Immigration and Customs Enforcement custody in 2025, according to internal reviews posted on — and later removed from — ICE’s website.

The reviews found that staff across multiple ICE detention centers mismanaged medication, skipped physical exams, ignored lab orders, and delayed treatments for sick detainees. Detention staff often failed to properly document or communicate the status of their deteriorating patients. In several cases, they failed to provide timely or appropriate life-saving care during emergencies.

“Rampant systemic medical abuse is a core feature of the immigration detention system.”

“Rampant systemic medical abuse is a core feature of the immigration detention system.”

“It’s very clear that the rampant systemic medical abuse is a core feature of the immigration detention system,” said Stacy Suh, program director of the Detention Watch Network, upon reviewing the topline findings. “You can’t get well in a detention center.”

At least 56 people have died in ICE custody under the second Trump administration. ICE’s own Health Services Corps conducts a “mortality review” following an in-custody death to assess whether appropriate medical care was provided. The findings of this report are based on medical records and staff testimony. (ICE did not immediately respond to a request for comment.)

A total of eight such reviews related to detainee deaths from 2025 were published in a trove of 25-plus documents on ICE’s public records library on September 25. Four days later, a little after a lawyer representing this reporter in a Freedom of Information Act lawsuit noticed these documents, ICE appeared to have pulled them offline and de-indexed them.

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While they were no longer available through internet searches, the records remained live on internet archives of the webpage. The larger trove of mortality reviews was first reported on by The American Prospect and the San Francisco Chronicle.

The eight reports contain granular details of the medical events leading up to 2025 deaths in custody of Johnny Noviello, Lorenzo Antonio Batrez Vargas, Marie Ange Blaise, Nhon Nguyen, Oscar Duarte Rascon, Santos Reyes Banegas, Tien Xuan Phan, and Chaofeng Ge. They provide the most comprehensive view yet into the escalating death toll in detention during President Donald Trump’s second term.

“Egregiously Managed Care”

The mortality review for Vargas, a 32-year-old from Mexico, found several clear examples of what ICE’s reviews called “inappropriate” care.

Vargas had complained of dizziness and blurred vision upon arrival at the Florence Detention Center in Arizona on August 4 last year. His labs also showed signs of uncontrolled diabetes. Ten days later, Vargas tested positive for Covid and was moved to a medical unit for isolation. His symptoms were treated with just a one-time dose of acetaminophen.

When Vargas’s chest X-rays later showed signs of........

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