In many cases, Dr. Amin’s patients said they were confused about why they ended up being sent to his office in the first place — some after raising medical issues that had nothing to do with gynecology.
Yuridia, a 36-year-old immigrant from Mexico, sought out a nurse at the center soon after she arrived because she was having pain in her rib after a fight with her abusive ex-partner just before she was picked up by ICE. She asked to be identified by her first name because she feared for her safety.
She was sent for a medical exam at Dr. Amin’s office, where she said he began to prepare an ultrasound machine. “I was assuming they were going to check my rib,” she said. “The next thing I know, he’s doing a vaginal exam.”
Dr. Amin recorded in his notes that Yuridia had cysts in her ovaries and scheduled a surgery to remove them. He also wrote that she had complained of heavy menstruation and pelvic pain. She said that she never experienced or reported those conditions and that she had not asked to see a gynecologist.
Weeks later, she underwent surgery. Pathology reports show that she did not have dangerous cysts, but small ones of the kind that occur naturally in most women and do not call for surgical intervention.
Yuridia said she had expected only a minor procedure that would be performed vaginally, but she was surprised when she woke up to find three incisions on her abdomen and a piece of skin missing from her genital area.
“I woke up and I was alone, and I was in pain and everyone spoke English so I could not ask any questions,” Yuridia said. Three days later, still sore and recovering, she was deported.
Yuridia’s case bears striking similarities to others that the panel of doctors reviewed. Many of them led to two surgical procedures performed simultaneously: “dilation and curettage,” often referred to as a “D & C,” which involves inserting tools into a woman’s vagina and scraping tissue from the uterus, and laparoscopy, in which three incisions are made to insert a camera into the abdominal cavity to examine or perform procedures on the reproductive organs.
The cases suggest a pattern of “excessively aggressive surgical intervention without adequate trial of medical remedies,” Dr. Ottenheimer said.
A report reveals longstanding complaints
It was the Irwin County center’s handling of the coronavirus pandemic that inspired Ms. Wooten, the nurse whose whistle-blower complaint was first reported by The Intercept, to come forward about another issue that troubled her: Dr. Amin’s surgeries. She said in an interview that she had for years noticed that an inordinate number of women were being referred to Dr. Amin. She said she would hear reports that they had undergone surgeries but that they had no idea why the surgeries were performed.
“After they get up from general anesthesia,” Ms. Wooten said, the women would ask, “Why’d I have this surgery?”
“And I don’t have an answer for why,” she said. “I am just as shocked as they are. Nobody explained it to them.”
Data from ICE inspection reports show that the center, which is operated by a private prison company, Lasalle Corrections, refers more than 1,000 detainees a year for outside medical care, far more than most other immigration detention centers of the same size. It is not clear how many of these referrals are for gynecological care. Lasalle Corrections did not respond to requests for comment.
Concerns from women detained at Irwin emerged long before Ms. Wooten came forward.
Ms. Dowe, after being told by Dr. Amin that she had a mass the size of a “cantaloupe” on her uterus, had reached out in early 2019 to Donald Anthonyson, an immigrant advocate she had met through a fellow detainee. She was asking for help, Mr. Anthonyson said.
“She expressed real concerns about going to that doctor,” he said. “She was concerned about what was happening to her and what she was hearing from other women.”
Unlike some of the women who had no gynecological complaints, Ms. Dowe was experiencing intense menstrual cramping, which the doctors who reviewed her case said could sometimes justify the procedure she underwent — but only if the patient understands the options and elects to move forward. Even then, the doctors raised questions about several seemingly healthy and naturally occurring cysts that Dr. Amin might have removed unnecessarily while he was operating on her.
After the procedure, Dr. Amin wrote in his notes that Ms. Dowe requested a second surgery — a full abdominal hysterectomy and removal of her ovaries.
But Ms. Dowe insists she never made any such request. A note in her medical records from the detention center appears to corroborate her denial. “Detainee is requesting a second opinion to have a hysterectomy,” it reads, “OB/GYN scheduled hysterectomy and patient refused.”
Complaints about Dr. Amin had also been raised with senior officials long before Ms. Dowe’s case.
In November 2018, a woman named Nancy Gonzalez Hidalgo was left shaken after several visits with the physician, during which she said he performed rough vaginal ultrasounds and ignored her when she cried out in pain. Ms. Gonzalez Hidalgo’s lawyers sent an email to the warden of the center, David Paulk.
In the email, Erin Argueta, a lawyer at the Southern Poverty Law Center, explained that Ms. Gonzalez Hidalgo’s health was worsening because of complications she was experiencing from an earlier miscarriage.
“Nancy hesitated to seek medical attention because her last experience with Dr. Amin was so painful and traumatic that she did not want to be sent back to him,” Ms. Argueta wrote.
She referred in her email to several previous verbal complaints about Dr. Amin that lawyers had taken to the center’s inmates services director, Marteka George. “Ms. George stated that this was not the first time someone complained about Dr. Amin, and she said that she would look into whether Nancy could see a different provider,” the lawyer wrote.
The warden responded twice, stating on Nov. 30 that Ms. Gonzalez Hidalgo had been scheduled for an appointment with an outside provider “that is unassociated with Dr. Amin.” The other doctor, Warden Paulk said, was “reportedly well thought of by his patients.”
Warden Paulk did not respond to requests for comment.
Other women who questioned Dr. Amin’s care in the past said they had also faced challenges when they tried to seek answers.
On the morning of Aug. 14, Mileidy Cardentey Fernandez said, there was no interpreter present at the Irwin County Hospital when she was presented with consent forms in English to sign for a procedure she was undergoing that day.
She asked the technician, “Spanish, please? Little English.” The woman urged her to sign the forms — and so she did.
Afterward, she said, she filled out a form on numerous occasions at the detention center requesting her medical records but got no response.
“I wanted to know everything they had done,” she said. “I made requests for the biopsy, analyses, and they don’t want to give them to me. They said they don’t have the results. How can they not have the results?”
When she was released from detention on Sept. 21, she called her daughter in Virginia and then headed straight to Dr. Amin’s clinic with her lawyer to demand her records, which she received.
Some women said they had managed to avoid surgeries by Dr. Amin but not without facing resistance.
Enna Perez Santos said she objected when Dr. Amin suggested that she undergo a procedure similar to the ones that other women had complained about. Dr. Amin, she said, counseled her that it was a mistake to forgo the treatment and he wrote in his notes that she had asked to speak to a mental health care provider.
Back at the detention center on the same day, Ms. Perez Santos was given a psychiatric evaluation. “I am nervous about my upcoming procedure,” Ms. Perez Santos told the examiner, according to the practitioner’s notes. “I am worried because I saw someone else after they had surgery, and what I saw scared me.”
Ms. Perez Santos was brought three more times to Dr. Amin’s office over the next several months, she recalled. Each time, she said, Dr. Amin raised the prospect of a surgery. She felt “pressured” to agree, she said, but each time she told him she did not consent.
Three board certified gynecologists who reviewed Ms. Perez Santos’s medical files say that her instincts appear to have been correct. “Based on what I see here, Amin was inappropriately suggesting a D & C scope,” Dr. Ottenheimer said. “There is nothing at all there to support the procedure.”
Kitty Bennett contributed research.