ARI SHAPIRO, HOST:
The government says 163 people have died since 2003 in the custody of the Immigration and Customs Enforcement Agency. Here's the story of one of them. A Mexican immigrant, 31 years old - his life ended almost two years ago in an ICE detention center in an Arizona desert town. He died by choking on an orange prison sock that he had stuffed down his own throat. Those circumstances and the unusual cause of his death raise questions about medical care and safety standards in detention. An investigation into this case has identified deficiencies in that Arizona center. Here's Maria Hinojosa, host of NPR's Latino USA, with a story of the immigrant's journey, his death and what we know of his time in ICE custody.
MARIA HINOJOSA, BYLINE: On May 13, 2015, Jose de Jesus Deniz Sahagun celebrated his 31st birthday in central Mexico. The next day, he traveled to the U.S.-Mexico border to cross into the United States without authorization. He was headed for Las Vegas where he had lived for many years hoping to be reunited with his three young children. But things didn't go as planned.
Nobody knows exactly what happened that night. But Deniz Sahagun called his family at some point saying he was in danger as he ran up to the port of entry. That's when he turned himself into the Border Patrol and asked for help.
GABRIEL DENIZ: He was in good hands. That was my first thing.
HINOJOSA: Deniz Sahagun's brother Gabriel, who lives in Las Vegas, was relieved to hear he was in custody.
DENIZ: Because after that we can get a lawyer - do something. Take him to court or whatever we can do for him.
HINOJOSA: Border Patrol agents said in an internal investigation by the Office of Detention Oversight that Deniz Sahagun was hysterical. And when he was put into a holding cell, he jumped off of a bench and landed on his head twice. Deniz Sahagun told agents he was doing this so he could kill himself before being killed by the Border Patrol or by drug traffickers.
Deniz Sahagun was taken to a hospital about an hour north in Tucson. At the emergency room, he was treated for his head injuries and given a neck brace. But what he didn't get was a psychiatric evaluation even though he told hospital staff he hurt himself on purpose. The hospital in Tucson cited federal privacy laws for not commenting on this case.
Later that day, he was released from the hospital and taken to the Eloy Detention Center in the small desert town of Eloy, Ariz. The facility holds about 1,600 immigrants and is owned and operated by the Corrections Corporation of America. CCA is one of the largest private prison companies in the U.S., and officials there declined requests for an interview for this story. Recently, the company changed its name to CoreCivic.
Records show that once inside the detention center, Deniz Sahagun continued to hurt himself.
GREGORY HESS: Trying to bang his head against the wall, saying people were going to kill him, just kind of bizarre behavior.
HINOJOSA: That's Gregory Hess, the Pima County medical examiner who performed the autopsy on Deniz Sahagun and also reviewed his medical files.
HESS: He was seen by a psychologist at that facility who put him on a constant suicide watch.
HINOJOSA: Under suicide watch, Deniz Sahagun was only allowed to wear a smock and had a guard watching him 24 hours. By the next morning, his third day at Eloy, the psychologist wrote that Deniz Sahagun seemed to be doing better, so he downgraded his level of supervision. He was given his clothes back, remained in solitary but with a guard checking on him every 15 minutes. That's the day Jose de Jesus Deniz Sahagun died, May 20, 2015. He died by asphyxiation. The autopsy later discovered he had stuffed a sock down his throat.
HESS: The sock was bunched up but essentially was molded into the esophagus. So I imagine he had to work to make that happen a little bit, but that - that's how it was.
HINOJOSA: Deniz Sahagun's death while in custody raised questions about the conditions of immigrant detention. A 2013 Migration Policy Institute report showed that more money is spent on immigration enforcement and detention than on all other forms of federal law enforcement combined.
ALLEN KELLER: My name is Dr. Allen Keller.
HINOJOSA: Dr. Keller directs a program at New York University on the intersection of health care and human rights. He's been following this issue for two decades and says that although there have been some improvements, there are still many issues with immigrant detention.
KELLER: They are held in prison-like conditions monitored by guards who come from a correctional mindset.
HINOJOSA: Even though the majority of immigrants detained are not violent criminals. Dr. Keller reviewed Deniz Sahagun's case thoroughly and questioned the detention center's policy of putting suicidal detainees in solitary. The rationale for that is that they can be monitored more easily and would be less likely to hurt themselves. But Dr. Keller says that only works when somebody is in immediate danger. After that, doctors need a treatment plan.
KELLER: Why was this individual in immigration detention in the first place, and did he need to be?
HINOJOSA: The Office of Detention Oversight report on Deniz Sahagun was released more than a year after his death. It pointed to a series of small errors, painting a picture of deficiencies in how the Eloy Detention Center handled this case. For one, the report found that the doctor took him off of suicide watch without filling out a proper mental health evaluation. The investigators also found that Eloy had no mental health providers on call after hours - a breach of ICE healthcare standards.
Surveillance video from outside Deniz Sahagun's cell shows that once the guards found him unresponsive, they waited for a protective shield for seven minutes before entering his cell. A handheld video taken by one of the guards offers a three-minute look inside the cell. The first thing staff did once they went in was to handcuff Deniz Sahagun. Dr. Keller says the first thing should've been to check to see if he was breathing.
KELLER: The first thing going through their head was not, A, for airway, it was, S, for safety. And that's in many ways understandable. Between the handcuffing and then uncuffing him - that's precious time. The clock of life and saving a life is ticking.
LIZ CEDILLO-PEREIRA: Is it a perfect scenario - certainly not. But we are constantly looking at ways where we can improve it.
HINOJOSA: That's Liz Cedillo-Pereira, the senior adviser to the director of ICE. She says suicides in detention are rare, but the agency takes them seriously.
CEDILLO-PEREIRA: Out of more than 300,000 people who were brought into our facilities last year, one individual took their life. Of course, that's unfortunate. We think that one is too many. But this does tell us that our protocols to prevent these types of scenarios are being effective, largely speaking.
HINOJOSA: Overall, there have been seven suicides in ICE custody since 2005, and five of them took place at Eloy making it by far the facility with the most immigrant suicides in the country. Deniz Sahagun's suicide was the third there in three years. Despite that, the ICE internal investigation found that Eloy lacks a suicide prevention plan and said it should develop one. Meanwhile, Deniz Sahagun's brother Gabriel says he believes the suicide could have been prevented.
DENIZ: This can happen to another family today, tomorrow. We don't know. They don't think like if they're helping a family member. It's a person. No matter what, it's person.
HINOJOSA: Jose de Jesus Deniz Sahagun was buried in Mexico in the summer of 2015 in a little cemetery near the Pacific Ocean close to a place that once was his home and far from the place he wanted home to be. For NPR, I'm Maria Hinojosa.
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SHAPIRO: Tomorrow on MORNING EDITION, we'll preview a Supreme Court case centered on the U.S.-Mexico border. The question - can a U.S. Border Patrol officer be sued for damages after shooting an unarmed Mexican national standing on the other side of the border?
UNIDENTIFIED MAN #1: It was clear that, in my opinion, he was defending himself.
UNIDENTIFIED MAN #2: It means that a law enforcement officer standing in the United States is immune from the U.S. Constitution when exercising deadly force right across the border.
SHAPIRO: The Supreme Court hears arguments in that case tomorrow, and NPR legal affairs correspondent Nina Totenberg takes us through the details on MORNING EDITION.
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