Immigrant detainees in U.S. government custody are getting inadequate medical, dental and mental health care, and they face potential punishment for speaking out, according to a report issued Monday by Democrats on the House Homeland Security Committee.

Citing inspections of eight private and county-run detention facilities overseen by U.S. Immigration and Customs Enforcement (ICE), the report said guards threatened to lock detainees in isolation cells in retaliation for making too many complaints or medical requests. The committee said its staff spoke to 400 detainees.

“The Committee’s review of the conditions at ICE detention facilities confirms that ICE does not do enough to ensure that its own standards of confinement are met,” the report says. “Conditions at ICE facilities also revealed ongoing problems with cleanliness, use of segregation, and access to legal and language services.”

In one instance described in the findings, an ICE detainee in Louisiana went into anaphylactic shock four times in four months before blood tests were administered that determined the man had a peanut allergy. At a jail in New Mexico, where an inspector made an unannounced visit, the facility was “a mess” and 300 sick calls by detainees had gone unanswered, while immigrants with chronic conditions lacked routine care.

ICE said it would take the findings seriously and look into the allegations.

“U.S. Immigration and Customs Enforcement appreciates the efforts of the committee and intends to closely review the report,” ICE spokeswoman Danielle Bennett said in a statement. “ICE welcomes any recommendations that help improve agency processes and ensure that civil detention operations provide a safe and secure environment for detainees.”

“The health, welfare and safety of ICE detainees is one of the agency’s highest priorities,” Bennett added.

ICE officials note the agency has established several layers of monitoring and oversight to ensure compliance with national detention standards. The agency has a “Detention Monitoring Council” that meets quarterly, and a subcommittee that convenes monthly to review detention-related incidents, officials said.

The committee’s report said the facilities it toured were generally clean, but it also noted several of the sites appeared to have been spruced up before inspectors’ scheduled visits. The report questioned the private detention companies’ use of detainees to clean and otherwise perform unpaid labor while in custody.

ICE has struggled in recent months to contain transmission of the novel coronavirus in its facilities, one of the problems noted in the report. “The spread of COVID-19 has further highlighted how the failures to meet these standards of care are a matter of life and death,” the report found.

On Monday, a 61-year-old Mexican national in ICE custody died in Georgia, the agency’s eighth coronavirus-related death, the agency confirmed.

One of the biggest coronavirus outbreaks in the ICE system occurred at an immigration jail in Farmville, Va., this summer after the agency transferred 74 detainees from Florida and Arizona to the facility in early June.

ICE said the transfers were intended to avoid overcrowding, but current and former officials said the primary purpose of the transfers was to allow ICE to skirt restrictions on the use of charter flights for employee travel. ICE used the detainee flights to rush tactical officers to D.C. on June 2 to help contain protests on the streets of the nation’s capital.

The report follows allegations made last week by a former nurse who worked at the Irwin County Detention Facility in southern Georgia, one of the more than 200 detention facilities ICE uses nationwide. The nurse, Dawn Wooten, said the facility failed to adhere to coronavirus safety protocols, and she also alleged that a large number of unwanted hysterectomies have been performed on detainees by a local doctor known as “the uterus collector.”

The allegations of mass hysterectomies have not been substantiated, but several detainees and attorneys representing others said women have been subjected to gynecological treatments they did not consent to or fully understand.

Rep. Bonnie Watson Coleman (D-N.J.), one of the committee members who held a virtual hearing Monday to discuss the Democrats’ report, called Wooten’s allegations of sterilization procedures on ICE detainees “one of the most inhumane things I have ever heard.”

ICE said it is taking Wooten’s claims seriously, but a review of its records indicates that just two women from the facility have been referred for hysterectomy procedures since 2018 based on the recommendations of specialists. The Department of Homeland Security has launched a separate inquiry into Wooten’s claims.

The committee report called for the Government Accountability Office to initiate a wider inquiry into ICE treatment of detainees.

“When we detain people, we have an ethical and legal duty to adequately protect their health,” said Scott Allen, a medical adviser to DHS who joined the committee panel Monday, adding that the report presented “a compelling obligation to urgently make corrections.”