Emmanuel Clifford Damas was 56 years old, from Haiti, and he died of a tooth infection. His brother says ICE never let him see a dentist. A tooth infection is one of the most treatable medical problems a person can have — antibiotics, an extraction if it comes to that, a few days of discomfort. It is not supposed to be fatal in a facility with medical staff on-site, contracted specifically to provide exactly that kind of care. During the same years Damas and dozens of others died of conditions that shouldn't have killed anyone, ICE's own inspection system rated the detention facilities under its watch "acceptable" or above in 238 of 241 reviews. Both of those facts are documented. Only one of them should make you feel better about what's happening inside these buildings.
What the Written Standards Require
Documented fact: ICE's detention standards (covering both the older 2011 Performance-Based National Detention Standards and the revised 2025 National Detention Standards) require facilities to provide access to medical, dental, and mental health care, including intake screening, access to prescribed medications, and emergency care. These are ICE's own published requirements — the standard Damas's own facility was supposed to be held to.
The Named Cases Behind the Aggregate Numbers
Documented fact: Alberto Gutierrez-Reyes, 48, from Mexico, had diabetes and high cholesterol; Los Angeles City Councilmember Eunisses Hernandez said he was denied access to the medical care his conditions required. A detainee identified in congressional correspondence as Gantchev died at the North Lake Correctional Facility; Representatives Delia Ramirez and Rashida Tlaib formally raised concerns that staff had failed to respond to his repeated requests for help before he died. Separately, GEO Group is being sued by a former detainee who says he was denied prescribed antibiotics and other necessary emergency care while in custody, and was hospitalized immediately after release to prevent sepsis — his body having been left, by his account, to fight a treatable infection alone until it nearly became untreatable.
The Watchdog's Own Building
The U.S. Government Accountability Office headquarters in Washington, D.C. GAO's 2025 review of ICE detention inspections is a central source for this piece. Photo: ajay_suresh, CC BY 2.0, via Wikimedia Commons.
What Formal Inspections Say, in the Same Years
Documented fact: A 2025 GAO review found that ICE's Office of Detention Oversight rated facilities "acceptable" or above in 238 of 241 inspections during fiscal years 2022 through 2024, and that ICE Health Service Corps inspections found 46 of 47 inspected facilities in compliance with applicable standards. The same report found DHS has not defined clear performance goals or measures for its inspection programs — meaning there's no established way to know whether a passing score reflects real conditions or just a completed checklist. DHS's own Office of Inspector General has previously found that Nakamoto Group, the contractor conducting most routine inspections, used inconsistent practices, conducted inadequate detainee interviews, and relied heavily on reviewing written policies rather than directly observing actual facility conditions. Interpretation: a near-perfect pass rate produced by that kind of inspection process is not evidence that Damas, Gutierrez-Reyes, and Gantchev's deaths were exceptions to otherwise-adequate care. It's closer to the opposite: a documented explanation for how deaths like theirs kept happening inside a system that kept grading itself "acceptable" anyway.
DHS Office of Inspector General
Whose prior findings on inspection-contractor methodology are described above. Image: DHS OIG, public domain, via Wikimedia Commons.
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Overcrowding Made It Worse, and Everyone Watching Knew It
Documented fact: At Camp East Montana — the same El Paso, Texas facility where Geraldo Lunas Campos died, and where Human Rights Watch and the ACLU documented staff routinely beating detainees — at least 14 detained people tested positive for measles by mid-2026, in a facility holding as many as 1,500 people with limited vaccination records and rapid population turnover through shared air. A separate outbreak hit ICE's Florence, Arizona facility, with DHS confirming seven active cases. On the record: Rep. Veronica Escobar, whose district includes Camp East Montana, said serious medical issues were being overlooked there, and that in some cases medical attention for urgent health problems was "non-existent."
Bottom Line
ICE's written standards require real medical, dental, and mental health care. Its own inspection system says facilities are meeting that standard almost every time it checks. And in the same stretch of years, a man died of an untreated tooth infection, another died after his family says staff ignored his repeated requests for help, a third was hospitalized for sepsis right after his release, and measles spread through overcrowded facilities with no reliable vaccination records. A 99% pass rate next to that record isn't reassuring — it's evidence the checking itself doesn't work.
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A system that grades itself "acceptable" while people inside it die of tooth infections and untreated sepsis is exactly the institutional pattern this Anti-Fascism design calls out.
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Frequently Asked Questions
If facilities mostly pass inspection, is the medical care problem overstated?
The named cases in this piece say otherwise. A high pass rate from an inspection process DHS's own watchdog has criticized for inadequate methodology isn't stronger evidence than a documented death from an untreated tooth infection — it's weaker evidence, from a process that isn't built to catch what actually happened.
Who conducts these inspections?
A mix of ICE's own Office of Detention Oversight, ICE Health Service Corps, and contracted inspectors including the Nakamoto Group, whose methodology has been specifically criticized in DHS OIG findings.
Has anyone been held accountable for these specific deaths?
We did not find a published disciplinary or corrective action tied to the Damas, Gutierrez-Reyes, or Gantchev cases specifically as of this writing; the GEO Group lawsuit remains active litigation.
Related Reading
Rapes and Deaths in ICE Custody: What the Records Show: the fuller death toll these named cases are part of, including Geraldo Lunas Campos at the same Camp East Montana facility.
When Detention Standards Aren't Followed: What Actually Happens?: what's formally supposed to happen — and what watchdogs found actually happens — when a facility fails an inspection.
Fact-Check: Is "Detention Meets Standards" an Exaggerated Claim?: a closer look at exactly the pass-rate-versus-reality gap documented above.
Sources: U.S. GAO, "Immigration Detention: DHS Should Define Goals and Measures to Assess Facility Inspection Programs," GAO-25-107580; KFF, "Deaths and Health Care Issues in ICE Detention Centers Under the Second Trump Administration"; The Appeal, "Deaths in Detention Warn of Horrors Behind ICE's Prison Walls," featuring the Emmanuel Clifford Damas and Alberto Gutierrez-Reyes cases; letter from Reps. Delia Ramirez and Rashida Tlaib on the Gantchev case at North Lake Correctional Facility; El Paso Matters, "Nearly 180 ICE detainees quarantined for possible measles exposure in El Paso," featuring Rep. Veronica Escobar; KJZZ, "Arizona ICE facility reports 7 measles cases"; DHS Office of Inspector General, prior findings on Nakamoto Group inspection methodology.
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