An independent medical review team has submitted a report to Congress on a lack of informed consent and “disturbing pattern” of questionable gynecological surgical procedures at the Irwin County Detention Center in Georgia, after an account from a nurse whistleblower in September prompted congressional and federal investigations. At least 19 women, most of whom are Black and Latina, have come forward to allege they were pressured into “unnecessary” gynecological treatment and surgeries — including procedures that left them sterile — while they were detained by Immigration and Customs Enforcement. We speak with Jaromy Floriano Navarro, a survivor of medical abuse and neglect at Irwin who was the original source of the information about medical abuse by Dr. Mahendra Amin that was eventually included in the whistleblower report. “From day one that I met Dr. Amin, he said, ‘OK, you need surgery,’” Navarro says. “They were really trying to do the surgery on me, for whatever reason. They wanted to take my womb out.” We also speak with Dr. Maggie Mueller, an assistant professor of obstetrics and gynecology at Northwestern Medical Center who was part of the independent medical review team that produced the new report, and Adriano Espaillat, Democratic congressmember from New York who visited the Irwin County Detention Center in September as part of a delegation from the Congressional Hispanic Caucus.
This is a rush transcript. Copy may not be in its final form.
AMY GOODMAN: At least 19 women have now come forward to allege they were pressured into unnecessary gynecological treatment and surgeries, including procedures that left them sterile, while they were imprisoned by Immigration and Customs Enforcement at the Irwin County Detention Center in Georgia. The women are mostly Black and Latina. They were all patients of Dr. Mahendra Amin, the primary gynecologist linked to the jail.
In a shocking new report submitted to Congress Thursday, an independent medical review team of nine board-certified OB-GYNs and two nursing experts examined more than 3,200 pages of the women’s medical records and said they found a lack of informed consent and a, quote, “disturbing pattern” of questionable gynecological surgical procedures. Today they’ll present their findings to the Senate Democratic Caucus.
This comes after whistleblowing nurse Dawn Wooten first spoke out in September about an alarmingly high rate of hysterectomies performed on women at the ICE jail, prompting congressional and federal investigations. An ICE spokesperson said the allegations in the new report raise, quote, “serious concerns that deserve to be investigated quickly and thoroughly.” Meanwhile, the private prison company that operates Irwin, LaSalle Corrections, said it could not comment during the impending investigation.
For more, we’re joined by three guests. Jaromy Floriano Navarro is a survivor of medical abuse and neglect at Irwin. She was the original source of the information about a medical abuse by Dr. Mahendra Amin that was eventually included in the whistleblower report. She is in Mexico right now.
Also with us, from Chicago, Illinois, is Dr. Maggie Mueller. She was part of the independent medical review team that produced the new report. She’s an assistant professor of obstetrics and gynecology at Northwestern Medical Center.
And we’re joined by Democratic Congressmember Adriano Espaillat of New York, who was part of a delegation from the Congressional Hispanic Caucus that visited the Irwin County Jail in September, where he met with jailed women who allege Dr. Amin conducted unnecessary medical procedures on them without their full knowledge and consent. Congressmember Espaillat is the first Dominican American and the first formerly undocumented immigrant to serve in Congress.
We welcome you all to Democracy Now! I want to begin with the doctor. Dr. Mueller, if you can talk about what you found happened at Irwin?
DR. MAGGIE MUELLER: Absolutely. So, what we were able to identify, there is really what we think is a concerning pattern of, number one, overly aggressive management of women’s complaints, or lack thereof complaints, actually, as well as significant lack of informed consent for these women who underwent procedures, that they then acknowledged they didn’t understand they were going to undergo.
AMY GOODMAN: And talk about how extensive this was, what these procedures were. We’re not talking about one woman or two women; we’re talking about at least 19 women. What were they told? Where did this happen? And how many do you understand were actually given hysterectomies without their knowledge?
DR. MAGGIE MUELLER: Yeah, so, I think that’s a very important point of clarification. So, as you said, we did review 19 cases where we had medical records of women who received care with Dr. Amin. What I mentioned is a pattern, the pattern of overly aggressive procedures. This is not necessarily focusing on hysterectomy or sterilization procedures, but still important surgical procedures that can have implications later on in life, so, for example, taking a patient that really didn’t have any gynecologic complaints, not working them up appropriately, and then performing additional procedures like a dilation and curettage or a diagnostic laparoscopic procedure, and then recommending even more aggressive therapy.
AMY GOODMAN: What does he gain by doing this? I ask this because in 2013 Georgia and federal investigators sued Dr. Amin — this is like seven years ago — the Hospital Authority of Irwin County and a group of other doctors over allegations they falsely billed Medicare and Medicaid. Does he make money off of these hysterectomies?
DR. MAGGIE MUELLER: Well, honestly, I think that’s outside of my ability to make a determination. I am an expert medical witness. I’m able to review medical records and determine whether or not the standard of care was breached. I can’t comment as to what the motivation behind this was, but certainly it warrants further investigation. And that’s what we are asking for with this report.
AMY GOODMAN: Well, I want to go to Jaromy Floriano Navarro. We are speaking to you in Aguascalientes, Mexico. Can you talk about when you were held at Irwin and what happened to you?
JAROMY FLORIANO NAVARRO: Yes, of course. I was held in Irwin from October 18th, 2019, all the way to September 15th, 2020. And I met Dr. Amin March of 2020, because I told the nurse that I had heavy cramps and that all I wanted was some medication, like ibuprofen or something. But instead, she sent me to Dr. Amin for my cramps, and I also had an infection, a vaginal infection.
And from day one that I met Dr. Amin, he said, “OK, you need surgery.” He did a ultrasound, vaginal ultrasound, with a wand. And I didn’t even know he was going to do that. To be honest with you, I didn’t know that I was going to have to take my pants off or lay on that bed and let him look at me. I didn’t know that. Nobody ever told me that I was going have a vaginal ultrasound. And from the moment —
AMY GOODMAN: Was he doing this in his office or at the Irwin jail?
JAROMY FLORIANO NAVARRO: No, it was not at the Irwin County Jail; it was at his office, yes.
AMY GOODMAN: So you were brought there from the detention facility. So, go on from there.
JAROMY FLORIANO NAVARRO: Yes, they took me there. I was there about 40 times from March to September, to be honest with you. He told me right off the bat; he said, “You have a cyst. And it’s not big, but it could grow. And we need to do a surgery.” That was the first time I had ever heard I had a cyst or seen him, and he told me right off the bat. I was super afraid. I didn’t know what a cyst was or how it formed. He didn’t explain to me none of the above. He didn’t care. He just wanted to do the surgery.
He gave medication for my infection, and then he said that he was going to put a Depo shot on me, because that would help the cyst go away. Basically, I didn’t have a choice. He said that Irwin County Detention Center is no good at keeping up with any medication and that the Depo shot would be the most effective and that it would work for my favor because I didn’t have to depend on Irwin County Detention Center to give me my pills, which it would be any other type of medication for hormones. So, I was left with no choice, and so I had to pick the Depo.
After the Depo, I was bleeding. I wasn’t bleeding heavy, but I was spotting for an entire month. And I told the nurse that I was spotting after the Depo. And I have two kids. I’ve had the Depo before. I had never experienced those type of symptoms.
They took me back to see Dr. Amin from March to July at least 25 times. They would take me out constantly to go see him. He would — he would always check me. If it wasn’t with his fingers, then it would be with the wand. And to be honest with you, it was uncomfortable each and every time. I didn’t like anything he ever did. I didn’t like his posture. I didn’t like the way he stood in front of me or rested his hand on my knee as he did the vaginal search or whatever he was doing. And it was uncomfortable, to be honest with you.
He kept telling me, every single time I would see him, that I was going to have a surgery. But for some reason, I never knew when the surgery was going to be. Finally, when it came time for me to have my second round or my second dose, whatever, my second round of the Depo shot, which was July 31st —
AMY GOODMAN: You’re talking about the drug Depo-Provera.
JAROMY FLORIANO NAVARRO: Yes, yes. He gave me that shot in March. Then he gave me that shot again in July, about the middle of July. He was supposed to give me the shot by the endings of June, but he didn’t. And that was the first red flag that I realized, because I thought to myself, “How is it that he doesn’t even know when it’s my third-month mark? He’s not even giving me the shot the way it’s supposed to be or by the time it’s supposed to be. How is it that my cyst is going to go away if he’s not doing this properly?” So, that was my first concern.
And I told the nurse; I told her, “How is it that he doesn’t have any medical records on his computer? Doesn’t that tell him when it’s supposed to be the third month? I don’t understand why he didn’t give me the shot by the endings of June.” When I complained, they took me back to see him, around June 12th. It was around the second week of July. It was me and Yuridia. We both went to see him. And he told her and me that we both needed surgery. That was also Yuridia’s first time seeing Dr. Amin.
AMY GOODMAN: She, too, an immigrant prisoner at Irwin.
JAROMY FLORIANO NAVARRO: Yes. She had the surgery performed. I denied it. So, July 31st was two weeks after we went to see him, and that was the day that it was recorded for me to have my surgery. To my knowledge, as far as the information I was able to collect, I knew that I was going to have my cyst drained, and that was it. That morning, when Ms. Vaughn [phon.] picked me up, she asked me — as they were putting on the chains on me, she asked me, “Do you know where you’re going, what procedure you’re going to have?” And I was like, “No. I think I’m going to see Dr. Amin to have my cyst drained.” And she smirked. She said, “Hmm!” And that was it. And I knew I heard her, but I was just like, “OK, that was odd. Whatever.”
And so, they took me to the hospital, which is about — conveniently, it’s about 15 — 15 to 10 minutes from Irwin County Detention, top. And so, we get to the hospital, and, you know, because of the pandemic, they have to do tests on us. They did the nose swab, and they checked my blood. They took me to the room to prep me. I had to sign papers saying — to my knowledge, because the nurse didn’t allow me to read the paper even though I wanted to. She didn’t allow me to read the paper, the consent form, which said that if anything happens to me during the surgery, they weren’t responsible. So I knew that she said that that’s what it said. And I thought it was just crazy. Like, how am I signing this paper, although Dr. Amin is telling me that I need this surgery before anything happens to the cyst inside my body? I signed the paper. They took me to the room. They prepped me up. They put the IV. I had to take my clothes off, wait for the anesthesia person to come and put the anesthesia on me to go to sleep.
Before the anesthesia person could come in and put me to sleep, Ms. Vaughn and I were speaking. And we were getting to know each other. She was very polite. She was showing me pictures of her kids, and we were talking there for a minute, when at the end of the conversation she said, “You know you’re having a hysterectomy.” I was going to have my womb removed. And I had heard that word before a lot in Irwin County, so I knew that a hysterectomy was to remove our woman parts. And when she said that, I looked at her, and I didn’t say anything. I just automatically prayed. I said, “Lord, did you hear what she said? That’s outrageous. What is she talking about?”
And as soon as I finished my thought, the other officer, who went to get food for them to eat, came back, and he told her, “Hey, they need to speak with you.” So, my heart just raced when he said that. My heart was already beating fast when she said I was going to have a hysterectomy, but when he said, “They need to speak with you,” I knew something wasn’t right.
And she came back in the room, and she told me, “They can’t do the surgery because you have antibodies for COVID.” My whole world sinked at the moment, and I thought I was going to die because of COVID. I mean, I’ve been locked in there. It’s dirty. They don’t feed us correctly. They don’t take care of us. They don’t care how many medical requests we put for COVID. They didn’t care. So, I just was like lost, you know, being in a place locked up all day every day with no sunlight, under constant LSD lights. It’s just constant illumination. It’s like a low grade of torture. So, I just — all of that just ran through my mind as they were telling me I had COVID, antibody COVID. And luckily, they couldn’t do the surgery on me. They couldn’t perform the surgery on me because of the antibodies. And the nurse came in the room and said that Dr. Amin was going to be pissed because he wasn’t going to be able to perform the surgery on me. And she took the IVs out, and they just told me they’ll reschedule it.
And Ms. Vaughn took me back to Irwin County Detention Center. They had to isolate me for a minute. And when they took me back to Irwin County Detention Center, they wouldn’t tell the other ladies that I had COVID. They told the ladies that I was going home, and that’s why they were taking out my stuff from the pod. But I was able to kind of tell them before I left, through the window, that I had COVID and that the reason why I wasn’t going back in there and they were taking my things out of there was because I had COVID.
And they rescheduled the surgery for August the 14th. They were in a rush to do this to me. I was supposed to be gone by the endings of July — by the endings of, excuse me, after July, August. I was supposed to be gone by August, but they held me there, just trying to do the surgery on me for an entire month and a half. That’s not normal. My appeal was over July 31st. I should have been gone two weeks after that, to be honest with you. That is how the process goes. My appeal lasted six months. I was already there for a long time. After that month of July, I was supposed to be gone, at least a week or two weeks later. But, no, they held me there. They were really trying to do the surgery on me. For whatever reason, they wanted to take my womb out.
I refused it, though. August the 14th, I refused that surgery. Before August the 14th, I was speaking with Ms. Hughes, and I was telling her, “Hey, there’s something not right, because the officer said I was going to have my womb removed, and I don’t appreciate that at all, because that’s not what I signed for. You guys never told me that’s what you guys were going to do. Dr. Amin said he was going to do a D&C. He said he was going to drain my cyst. He never said anything about going into my vagina, doing anything through my vagina. He said he was going to drain a cyst, that it was a 20-minute process, three holes on my stomach — one by my belly, by my womb and down, one a little under my womb by my vagina. That’s all he said. He never said anything about going to my vaginal area.” But when I told Ms. Hughes this, she changed her story about four times. She said that Dr. Amin had to request a heavy bleeding procedure, a heavy bleeding surgery on me, because, if not, then ICE would have not approved this process, this procedure.
AMY GOODMAN: Jaromy, when did you get deported in this process?
JAROMY FLORIANO NAVARRO: In this process, I got deported September 16, which is the day after the whistleblower report came out. And I was in shock when I found out that the day after this came out, I got deported, to be honest with you. After that —
AMY GOODMAN: Do you feel like they were deporting you so that you would not speak out?
JAROMY FLORIANO NAVARRO: Of course. Of course that’s why they were deporting me. I knew it. I came back from signing my deportation September 15th, which was the same day that I went back to see Dr. Amin. And he was pissed. He was like, “Why didn’t you get the surgery? Who told you to say no?” And I was like, “Excuse me? It was a misunderstanding. Stories were being changed. How was I supposed to say yes? I’m not going to undergo a surgery that I have no knowledge of.” He was angry, and they deported me the next day.
And that’s the day I found out, August — excuse me, September 15th, I found out that there was a report that went viral. And everybody in Irwin County Detention Center, the officers were all asking if it was me who had spoken up. And I just — I was like, “Yes, it was me. I told. I told a lawyer that you guys were doing illegal surgeries here, because that’s how I felt.”
AMY GOODMAN: Let me bring in Congressmember Adriano Espaillat. You went down to Irwin. You spoke with women there. You are Dominican American. You’re the first undocumented immigrant to be elected to Congress, formerly undocumented. Can you talk about what you found, how typical is Jaromy’s experience, and what the hearing today is all about in Congress?
REP. ADRIANO ESPAILLAT: Well, Amy, just first let me congratulate this young lady for her courage, as well as the whistleblower, who we met with the day before we visited the Irwin correctional detention center.
Look, as I heard her tell her story, the one thing that stood out is that she is very fluent in English. And most of the ladies there are not. And so, imagine being subjected to this kind of treatment and not really understanding what’s being said to you. So, this is a critical piece, because to have informed consent, as you said, Amy, you must understand what they’re telling you. You must understand what your options are and what your condition is.
And so, when we met with the ladies there, let me just say that I was really taken aback by the level of fear that they expressed. And there was one thing that they consistently asked for, was for us to protect them. They felt that if they spoke out, they would wind up in solitary confinement. And so, as the young lady just said, this was sort of like a low grade of torture.
And they expressed how aggressively they were being treated by this doctor. In fact, there was eight women that we spoke to, and two of them were Asian women from China, and they couldn’t — they didn’t have a translator there, so we couldn’t really speak to them. But out of the other six, four of them had been treated by Dr. Amin, so — and they all expressed concern as to the aggressiveness of the tests, the lack of information and, as such, the lack of an informed consent.
And so, this is the critical piece right here. Were they consenting to these very aggressive treatments or procedures? And if so — and if not, then, you know, they’re clear violation. And we’re calling for — I’m calling for the shutdown of the center and the arrest — any doctor that would subject his patients to this type of treatment anywhere in America could be subject to be arrested. And so —
AMY GOODMAN: So you’re calling for Amin’s arrest. Also —
REP. ADRIANO ESPAILLAT: I’m calling for —
AMY GOODMAN: — clearly, the detention center was working with him.
REP. ADRIANO ESPAILLAT: Well, that’s part of the — that should be part of the investigation. The detention center, as you know, is run by a privately owned corporation, LaSalle. We’ve got to follow the money and see whether there was any profit incentive to aggressively submit these women to these very aggressive procedures, that I suspect are also more expensive. And so they cost more money. So, we want to see whether there was also a profit incentive to subject the women to this kind of what the young lady calls low grade of torture. So, yes, there should be a very deep and extensive investigation on this. We want to know if this is just isolated, or is it a common practice in detention centers across America, as well.
AMY GOODMAN: How do you know the women who are being held there right now are not being subjected to the same thing?
REP. ADRIANO ESPAILLAT: That’s correct. They could continue to be — this doctor has a problem history with Medicaid fraud. And, as well, the women have expressed to us, the ones that we spoke to, their fear that they will be subjected to solitary confinement. We don’t know if they’re still big subjected to the same kind of treatment that they have been subjected to for many, many years. So, we are concerned. The whistleblower was very specific as to her denunciations. And we’re proud of her courage, as well. But this must be investigated. This is horrendous.
One of the women that I spoke to, a Dominican woman, told me that she was treated like an animal. And we were able to contact the Dominican Consulate in Georgia and Florida, in Miami, Florida. And five of the Dominican women, who wanted to either be released or deported back home, were sent back home. ICE alleged that the Dominican government never gave them the documents that they needed. When we called the Dominican government, the consulate, they told us that they were never contacted. So, this hurry to extend the stay there for as long as possible to get in these procedures is highly questionable, if not criminal.
AMY GOODMAN: Jaromy, two quick questions before we go. Did you say you were chained to the bed?
JAROMY FLORIANO NAVARRO: No, no, I was not chained to the bed.
AMY GOODMAN: And are you asking to be let back into the United States?
JAROMY FLORIANO NAVARRO: Of course I am. I deserve. I deserve to be let back in the United States.
AMY GOODMAN: And so, let me ask Congressmember Adriano Espaillat: Can Jaomy Floriano Navarro — how could this deportation be reversed, given what she has identified here? A Cameroonian, one of the Cameroonian women — two were deported, but one whose sterilization became very well known was actually taken off the flight in Chicago to be deported, so she has remained now in the United States. Can Jaromy Floriano Navarro — can you facilitate her return?
REP. ADRIANO ESPAILLAT: We will fight to bring her back. She is a victim. And she was subject to what she called a low grade of torture, what I think is also a low grade of torture. She should be allowed back in and treated. Certainly, my office will be willing to work with the lawyers and with her to see if there’s a way that we can bring her back to the United States.
I am also concerned that these women were readily and speedily ushered out of the United States to prevent them, to silence them, to keep them from saying their stories as the story was well and eloquently said today. It’s horrendous. This is the same kind of stories that we heard from the women that we interviewed at the detention center. And this must be fully investigated. Irwin must be shut down. Dr. Amin must be arrested.
AMY GOODMAN: I want to thank you all for being with us. Congressmember Adriano Espaillat is speaking to us, congressmember from New York, again, the first formerly undocumented immigrant to become a member of Congress. Jaromy Floriano Navarro, speaking to us from Mexico, where the U.S. deported her to, she is demanding to be let back into the United States, a survivor of Dr. Amin. And Dr. Maggie Mueller of the Northwestern Medical Center in Chicago, who has done the big report, that we will link to, talking about the number of women — almost 20 — that they know of, who experienced these kinds of threats or actual sterilizations or surgeries without proper informed consent.
When we come back, we share the story of a Palestinian American family living in Trump country, in the very conservative town of Appomattox, Virginia. We’ll speak to filmmaker Nadine Natour about her family. Stay with us.