ATLANTA — A young woman who was detained at Irwin County Detention Center for 17 months says a doctor performed three procedures she didn’t fully understand.
The 28-year-old woman, who asked to remain anonymous out of fear of retaliation, recently told her story to several members of Congress as they prepared to travel to the ICE facility in Georgia. A board-certified OBGYN also presented findings to the Congressional Hispanic Caucus and members of the House Judiciary Committee, claiming the surgeries appear to be unnecessary.
'I kind of felt rushed and pressured into doing it.'
The woman, whom we are identifying only as “Jane,” was detained by ICE in late September of 2018 and later sent to Irwin County Detention Center. Documents obtained by 11Alive, show she was detained after a fight with her sister. The charge of simple battery was dropped in January of 2019, but Jane remained in custody because she does not have legal status. Jane’s attorney negotiated her release in March of 2020 due to the pandemic.
Jane told 11Alive’s Hope Ford that when she first arrived at Irwin, she asked for her intrauterine device (IUD) to be removed because it was old and causing discomfort.
Medical records show in July of 2019, she saw Dr. Mahendra Amin.
“On my appointment with Dr. Amin, he removed it, it was a quick procedure and everything,” said Jane.
During the visit, Jane said Dr. Amin saw several cysts on a vaginal ultrasound and one caused alarm.
“(He’s) kind of showing me on the screen, but of course, I’m no doctor, so you could be showing me anything,” Jane said. “He said he was going to drain the cyst because one of them was the size of a golf ball.”
Jane said she and another woman were taken to Irwin County Hospital the following month and informed she would have a more invasive procedure than she originally thought.
“The transportation van came, they shackled us, searched us and took us to the hospital. And that’s when I was told I was having a D&C on that day.”
Dilation and curettage, commonly known as a D&C, is a vaginal procedure performed to scrap the lining of the uterus to check for causes of bleeding and diminish heavy bleeding.
But, Jane said she was uncomfortable with surgery and asked to speak to her attorney. However, she said she didn’t get the chance because a nurse made her feel pressured to continue with the medical visit.
“She was like, ‘Well, I’m pretty sure if you’re going to do all of that, then you won’t be having your surgery today. And if you don’t have your surgery today then it’s more than likely that ICE will not approve you to have it done later.’ So, I kind of felt rushed and pressured in doing it, like I didn’t have a choice, I either do it today or never.”
After the surgery, Jane said she awoke shackled to the hospital bed and experienced constant pain and bleeding for weeks afterward.
“I had about six bleeding episodes in that one month and it was about every 30 to 40 minutes that I had to change the pad. I basically felt like I was taking care of my own wound.”
'She had a normal part of her ovary removed.'
Months after Jane’s release from ICE custody, a whistleblower accused ICE officials at the Irwin County Detention Center of performing unnecessary “mass hysterectomies.”
Dawn Wooten worked full time as a licensed practical nurse at the facility in Ocilla, Georgia, until being demoted in July.
Although Wooten failed to name the doctor, NBC reports claim he is Dr. Amin.
Reports from NBC and the Associated Press found little evidence to back up the claim of “mass hysterectomies.”
On Sept. 25, Reps. Doug Collins and Austin Scott, R-GA, sent a letter to the DHS Inspector General questioning the credibility of Wooten’s claims.
In the letter, the Congressmen said Project South, the organization that originally filed Wooten’s complaint, “openly characterizes the U.S. government’s immigration laws as ‘draconian’ and ‘racist’, it is safe to assume this organization has a vested interest in furthering Ms. Wooten’s allegations in an effort to shut down the facility.”
However, when Jane heard of Wooten’s claims, she informed her attorney, Kimberlee Payton-Jones, that she and others had surgery while in Dr. Amin’s care.
Payton-Jones added, “The detainees were discussing it among themselves saying, 'Well, what’s going on that everyone has these cysts?' It would seem someone in ICE would raise a red flag.”
Jane also told members of Congress in a closed to the public ZOOM meeting about her experience at Irwin.
In a written version of her comments, Jane wrote “Since being released, several doctors have reviewed my medical records, and I learned that not only did Dr. Amin and his staff coerce me into having surgery, but that the surgery was completely unnecessary.”
Dr. Michelle Debbink is one of the doctors who reviewed her medical records. Debbink, a board-certified OBGYN from Salt Lake City, said Jane’s medical records show that, besides the D&C, two other procedures were performed.
The medical records, which 11Alive also reviewed, show Jane complained of bleeding and pelvic pain prior to the surgeries.
“Which were diagnoses to drive the indications for the D&C,” Debbink said.
Jane’s records also show a laparoscopy was performed, which is a procedure using cameras through the belly button to look at the ovaries and remove any cysts that may be concerning. Finally, Jane’s records show she had a cystectomy, or removal of a cyst from one of the ovaries.
Debbink said, “The pathology report from that portion of her ovary that was removed suggests that it was a completely normal part of her ovary, a benign part of her ovary called a follicular cyst.”
A follicular cyst, according to Debbink, is a common cyst many women can develop in their lifetime.
“The follicular cyst grows, the egg matures, the egg is released, the follicular cyst goes away, the cycle starts all over again,” said Debbink. “The follicular cyst is something we all recognize as being normal, not pathologic, not dangerous to the patient and doesn’t need to be removed, but that is what happened to this Jane Doe, she had a normal part of her ovary removed.”
Debbink said she reviewed four other patient reports, which she said all showed similar findings. Debbink explained that while a D&C can be justified if a patient is experiencing heavy bleeding, a laparoscopy and cystectomy may have been unnecessary.
“We wouldn’t recommend removing follicular cysts,” said Debbink. “I think there’s adequate documentation throughout the charts that I have seen that the removal of charts that I have seen that the removal of normal parts of the ovaries is a theme.”
Furthermore, Debbink said IUDs, like the one Jane had removed, can be replaced and are an alternative to help with any chronic bleeding Jane may have experienced. In addition, Debbink said the size of the cyst indicated in the paperwork would have made Debbink feel comfortable waiting to perform an invasive procedure.
“The cyst that was removed and sent to pathology, the largest dimension on it was 2 centimeters, which is significantly smaller than a golf ball. The idea that a relatively small follicular cyst or a small abnormal cyst would rupture spontaneously in a young, healthy person, is very hard for me to imagine that that would be the reason for such an urgent procedure to be performed.”
'What is happening here is horrific.'
After hearing Jane's and Debbink's accounts, 11 members of the Congressional Hispanic Caucus and the House Judiciary Committee visited Irwin County Detention Center.
Multiple representatives who met with women at the facility described a fearful climate. Women would see others returning from visits to the doctor sick and in pain, they said, and not want any procedures done on them.
If they refused, Reps. Pramila Jayapal of Washington and Nanette Barragán of California both described hearing of women who received shots or injections of Depo-Provera, a contraceptive drug.
“What is happening here is horrific,” Jayapal said in a press call following the visit.
Rep. Jayapal described a pattern of coercive medical practices on the women by Dr. Amin - invasive inspections, ultrasounds, and penetrative touching, without being asked for consent. Often, she said, they're told they have a cyst.
California Rep. Raul Ruiz, an emergency room doctor, however, described a "pattern of diagnosing ovarian cysts and recommending surgeries without informed consent."
Rep. Sylvia Garcia of Texas said there should be an investigation into whether the doctor, ICE, or the hospital profited off the surgeries or committed medical fraud.
Dr. Amin was the subject of a Justice Department investigation in 2015 for allegedly making false claims to Medicaid and Medicare. As a result, he and other doctors involved paid $525,000 in a civil settlement, according to the Justice Department.
'The evidence is beyond clear that any treatment … was medically necessary.'
Dr. Amin, through his attorney Scott Grubman, denied Wooten’s allegations.
Grubman sent 11Alive a detailed statement, reading in part:
“The evidence is beyond clear that any treatment Dr. Amin provided, whether for ICDC detainees or otherwise, was medically necessary, performed within the standard of care, and done only after obtaining full informed consent.”
The statement further describes Dr. Amin’s career treating detainees at Irwin County Detention Center, saying the practice started around 2017.
According to the statement, Dr. Amin views surgery as a last option and, “always attempts to treat his patients with more conservative treatment, including medicine and less invasive procedures, before even recommending surgery.”
As for claims patients don’t understand the procedures, “Dr. Amin explains that recommendation in detail to the patient. Dr. Amin explains why he believes the procedure is appropriate, any alternative treatments that might be available, and any and all known complications that might arise,” the statement continued.
Grubman referenced a recent Georgia Public Broadcast article, where Dr. Amin’s former patients and community members strongly defend the doctor.
11Alive asked to discuss Jane’s specific allegations. However, Grubman said he cannot discuss a patient’s medical history without having a signed HIPPA release.
Jane, who is currently seeking asylum in the U.S., fears retaliation if she reveals her identity and declined through her attorney to sign a release.
“If you go after ICE, they are going to expedite your removal and they will remove you as fast as can be,” said Jane.
Grubman pointed out Jane is making allegations regarding her medical care but has refused to sign a waiver so that Dr. Amin is legally permitted to respond.
Irwin County Hospital and ICE have also denied allegations of misconduct. A spokesperson for ICE told NBC News, "unproven allegations, made without any fact-checkable specifics, should be treated with the appropriate skepticism they deserve."
ICE later confirmed detainees will no longer be referred to Dr. Amin.
Meanwhile, Jane, who has two children who are US citizens, relocated to be with family as her attorney appeals her deportation.
“I still have these pains that I’m feeling every month without knowing what’s going on with my body," she said. “It’s going to take months and even years to get over an experience like that.”