Illegal Immigrants Received Poor Care In Jail, Lawyers Say

The physician who examined him requested that he see a urologist so that he could undergo a biopsy to test for cancer. Two months went by before the request was approved.

The urologist, John R. Wilkinson, said that Castaneda's wart "may represent either a penile cancer or a progressive viral based lesion" and said that it required "urgent diagnosis and treatment."

But Immigration Health Services officials denied an offer from the urologist to admit Castaneda for a biopsy as "not cost effective," according to the tort claim, a procedural step that probably will lead to a lawsuit. After the lesion started to bleed, fester and grow between June and August, the officials continued to deny doctors' requests for a circumcision and a biopsy, saying the procedures were "elective," not an emergency.

But the problem worsened. "I was surprised, because I was bleeding and it was hurting a lot," Castaneda said. "The only thing they gave me was Motrin. I couldn't sleep at night because it was hurting a lot. I was afraid for my life at that time."

After a fourth specialist ordered a biopsy in January for what he said was "most likely penile cancer," doctors scheduled the procedure. But Castaneda was released from the custody of ICE a few days before the examination, "presumably so it would not have to pay for the procedure," according to the claim.

Castaneda later went to the emergency room at Harbor-UCLA Medical Center in Torrance, Calif., where a biopsy determined he had cancer. His penis was amputated on Feb. 14, but the cancer had spread.

"I'm stressed out . . . thinking it could have been prevented," he said.

Shack said Immigration Health Services officials did not immediately schedule a biopsy because the urologists had a difference of medical opinion. "I don't see this as improper care. I think this is good care," he said. "It's just unfortunate that this had a bad outcome."

In a similar case involving a Liberian detainee in 2005, officials in York County, Pa., questioned the federal government's commitment to treating one of its detainees, Benedictus Yarzue, who was in deportation proceedings for various crimes, including manslaughter and illegal entry into the United States.

Yarzue filed a complaint at the York County Prison in March of that year: "I have a prostate problem which I am in pain. I went to see a doctor and she said I need to see a urologist." Immigration Health Services denied the request, frustrating the prison's medical staff, which referred the case to the county solicitor.

"Yarzue was very, very frustrating," said York County Solicitor Don Reihart. "INS was not providing the care we deemed was required. If they turned us down, we were put in a position to give the care and pay for it or move him somewhere else."

Shack recalled the case in a recent interview, saying the request was denied because the prison staff did not follow procedures such as educating Yarzue about correct care to avoid problems, giving him medicine and examining him to determine whether urine was properly expelled after his frequent trips to the bathroom.