This story was originally published by Prism.
After medical personnel induced an undocumented woman into a coma, administrators in a hospital in Allentown, Pennsylvania, are trying to deport her to the Dominican Republic, despite the risks to her life and her husband’s opposition. The hospital is pushing through its decision, known as medical deportation, even though it is technically illegal, as the federal government has the exclusive authority to remove individuals from the U.S.
“If they put her on a plane, my wife is going to die. They haven’t even put back the piece of skull they removed from her to relieve the swelling in her brain,” said Junior Rivas, who asked to use a pseudonym to protect his immigration status in the U.S. “My wife has a huge hole in her head, and on the side where the piece of skull is missing, something seems to be coming out.”
According to Rivas, his wife —a 46-year-old mother of two children—signed the admission paperwork herself at the Lehigh Valley Hospital-Cedar Crest on Dec. 28. One day later, she underwent what the medical staff told Rivas was a relatively simple procedure to treat her aneurysm. The surgery did not go as expected, and on Dec. 30, doctors put her under an induced coma. Since then, the hospital personnel asked Rivas if he “wanted to disconnect her.” When he declined, they kept insisting.
Rivas said the hospital gave him three options on Feb. 27: pay for $500 per-day equipment to take care of his wife in their home, find another U.S. hospital that would admit her, or consent to her deportation to the Dominican Republic. They gave him 48 hours to decide before they started her wife’s deportation arrangement. On March 2, Rivas received a letter in English from the hospital saying they would give him seven additional days to pick one of the choices presented to him.
A group of local nonprofits and grassroots organizations has been attempting to stop the deportation by bringing attention to the case and protesting at the hospital since March 1. This seems to be the only way to stop medical deportation, as hospitals and transportation companies rely on the fact that undocumented immigrants avoid bringing attention to themselves.
“Medical deportations are not legal,” said Lisa Sun-Hee Park, a professor at the University of California, Santa Barbara, and an author of a 2022 paper on medical deportations. “Only the federal government has the authority to forcibly remove an individual to another country. Unfortunately, there are a lot of gray areas here because hospitals are pretty adamant in saying that these are not deportations.”
The hospitals, however, tend to coerce individuals into agreeing to their own removal or that of their loved ones. So, medical deportations only come to light when the patient or their guardian disputes them and the legality of the action is questioned, Park said.
There is no official accounting or regulation of this practice, which happens without the involvement of immigration courts or the Department of Homeland Security, which is in charge of implementing immigration law and is the parent agency of Immigration and Customs Enforcement (ICE) and Customs and Border Protection (CBP).
Lacking oversight, medical deportations seem to happen on a massive scale. A sole hospital in Phoenix reportedly repatriated approximately 100 patients a year.
“I tried to look up every single case that has been talked about in the media or legal documents, and my best guess, conservatively, is that it is in the hundreds every year, but if I were more realistic, I would say it must be in the thousands,” Park said.
Growing Industry With No Accountability
Although consented medical repatriations are common, most medical deportees seem to be undocumented immigrants from Latin America—impoverished individuals transferred to subpar clinics in the region, as previously reported by Prism and The New York Times.
An industry has flourished. More than 350 airplane ambulances capable of medically deporting people operate in the U.S., according to the 2021 report “Fatal Flights. Medical Deportation in the U.S.,” by the Legislative Clinic at the University of Pennsylvania Carey Law School and Free Migration Project, a nonprofit advocating for abolishing deportations.
One company alone, MedEscort International, also based in Allentown, Pennsylvania, boasts about transporting over 6,000 patients to more than 100 countries. Its website allows access to it as “social worker or family member” or as “hospital CEO or CFO looking to solve the problem of unfunded foreign patients.”
The industry has financial incentives to expand medical deportations. Rivas said that he has identified a New York clinic that agreed to admit his wife, but as of March 2, the Lehigh Valley Hospital staff had not communicated with the New York option for a possible transfer.
“These people want to send my wife to the Dominican Republic,” he said.
For medical transportation companies, “this is their business model. They rely on these deportations to make revenue,” said Adrianna Torres-García, deputy director of the Free Migration Project. “These companies have a stake in coercing a patient into consent, along with the hospital, so that they can deport a person.”
Deporting Rivas’ wife may also relieve the Lehigh Valley Hospital–Cedar Crest —part of a multi-campus health care network in eastern Pennsylvania whose revenue jumped 11% from 2021 to 2022 to $3.8 billion—of another challenge: potential medical malpractice. Rivas contends that his wife may have been negligently damaged during the procedure to clip her aneurysm. The medical staff, he said, refuses to provide her medical records. Even though a hospital is legally obliged to provide medical records to the guardian of a patient, the staff has not done so as of March 2.
“I would not rule out medical malpractice. In other cases we’ve worked on, the family and the health advocates always had concerns whether the patient was receiving appropriate care,” said David Bennion, executive director of Free Migration Project. “Hospitals do all kinds of things to cover up that information, like not providing copies of the medical files.”
The Lehigh Valley Hospital Network president and senior vice president did not reply to Prism’s requests to comment on this story.
For now, Rivas is fighting—along with advocates, nonprofits, and grassroots organizations—to keep his wife in the U.S. (As of March 2, she remains in the Lehigh Valley Hospital). Otherwise, it will be harder to get any kind of accountability.
“As far as we are aware, no U.S. court has ever held a hospital or a transport company accountable for a medical deportation, even if it resulted in death or serious injury,” Bennion said. “There is no enforcement mechanism for this. So, effectively, it does not matter if these companies are breaking the law.”
Prism is an independent and nonprofit newsroom led by journalists of color. We report from the ground up and at the intersections of injustice.
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