May 17, 2023

Anadith Danay Reyes Alvarez, an eight-year-old Panamanian daughter of Honduran parents, died on her ninth day of being held in CBP custody with her family in Border Patrol’s Harlingen, Texas Station. The likely cause was influenza.

The family had turned themselves in to Border Patrol in Texas on May 9, 2023, two days before the Title 42 pandemic expulsion policy came to an end, a time when the agency was apprehending about 10,000 people per day. This may have prolonged their time in custody, although the Associated Press reported that by May 14, the average time in custody border-wide had fallen to 77 hours as the rate of new apprehensions dropped rapidly. Under normal circumstances, migrants are meant to spend no more than 72 hours in Border Patrol’s austere holding facilities.

According to a series of CBP statements and updates about Reyes’s case, on May 14th Reyes voiced complaints of abdominal pain, nasal congestion, and cough. That day, CBP-contracted medical personnel reported a fever of 101.8 degrees and a positive test result for Influenza A. In accordance with CBP protocol, the family was transferred to Harlingen Border Patrol Station for communicable disease medical isolation.

Reyes’s mother, Mabel Álvarez Benedicks, told the Associated Press that Border Patrol personnel, including medical contractors, repeatedly denied her appeals for medical aid, including an ambulance and hospitalization, in some cases just administering fever-reducing medication.

CBP reported that the family requested the medical personnel review Anadith’s medical documents to understand her medical conditions: a history of heart problems and sickle-cell anemia (original link). The parents made four requests for an ambulance. All requests were denied.

CBP acknowledged that medical personnel at the Harlingen Border Patrol Station refused to escalate Anadith’s level of care, even as her fever rose to 104.9 degrees early on May 16, the day before she passed. “Contracted medical personnel did not consult with on-call physicians (including an on-call pediatrician) about the girl’s condition, symptoms, or treatment,” the agency’s June 1 statement continued. “The contracted medical personnel failed to document numerous medical encounters, emergency antipyretic interventions, and administrations of medicine.”

The statement went on to note that “the camera system at Harlingen Station was flagged for repair/replacement on April 13. The outage was not reported to CBP OPR as required by H.R. 1158, Fiscal Year 2020 DHS Consolidated Appropriation.”

CBP reported nine medical encounters while the family was in the Harlingen facility. The mother requested emergency attention three times on the 17th; that day, the girl had a seizure, became unresponsive, and was transported to a hospital, where personnel declared her deceased within minutes.

“They killed my daughter, because she was nearly a day and a half without being able to breathe,” Álvarez Benedicks told the Associated Press. “She cried and begged for her life and they ignored her. They didn’t do anything for her.”

When she reported her daughter’s bone pain to an agent, she said he responded, “‘Oh, your daughter is growing up. That’s why her bones hurt. Give her water.’”

“I just looked at him,” Alvarez Benedicks said. “How would he know what to do if he’s not a doctor?”

“I felt like they didn’t believe me,” she said.

In an interview with ABC’s GMA3 program, Álvarez Benedicks said “she felt like medical personnel thought she was lying about how sick her child was feeling… She says Anadith told the staff ‘I can’t breathe from my mouth or my nose.’” The mother added her belief that she received poor treatment because she is Black: “I feel that since I got there they discriminated against me because of my skin tone and because I am an immigrant.”

In a May 21 statement, CBP “Senior Official Performing the Duties of Commissioner” Troy Miller informed that the agency would review cases of “medically fragile” people being kept in custody for long periods, and “will immediately initiate a review of medical care practices at CBP facilities and ensure the deployment of additional medical personnel as needed” (original link). The statement added that CBP had added more than 1,000 medical contractors to its facilities since 2021.

In a June 1 statement, Miller pledged other changes like reducing family units’ time in custody, deploying clinicians from the United States Public Health Service (USPHS) to CBP sites, ordering a review of the medical contractor’s practices at CBP facilities, and prohibiting several medical providers involved in the incident from providing care at CBP facilities (original link).

The Washington Post reported that on June 15 CBP transferred its chief medical officer, David Tarantino, to another assignment at DHS. (Tarantino’s position was created in 2020, after, as the Associated Press put it, “at least six children died during a roughly yearlong period from 2018 to 2019 during the Trump administration.”)

The Washington Post and Los Angeles Times reported on internal Department of Homeland Security (DHS) documents finding fault with CBP’s care for medically fragile migrants in the agency’s custody. The Post reviewed a June 8 internal memo from DHS acting chief medical officer Herbert O. Wolfe that found the Harlingen Border Patrol station “lacked sufficient medical engagement and accountability to ensure safe, effective, humane and well-documented medical care.” The memo, according to the Post’s Nick Miroff, “describes an ad hoc system with little ability to manage medical records, poor communication among staff and a lack of clear guidelines for seeking help from doctors outside the border agency.”

In his response to Wolfe, CBP’s Miller stated that he had ordered the relocation of medically vulnerable migrants from the Harlingen station, and halted the facility’s use as an isolation unit. He added that CBP is reviewing its medical record-keeping system and has told its medical contractor to “take immediate action to review practices and quality assurance plans to ensure appropriate care.” That contractor, Loyal Source Government Services, “received a $408 million medical services contract from CBP in 2020,” the Post reported.

The Los Angeles Times obtained documents from DHS’s Office of the Immigration Detention Ombudsman (OIDO) indicating that officials at one of the Texas CBP detention facilities where Anadith’s family was held had been “complaining about the facility’s ‘overuse of hospitalization.’” A May 22 memo reported by the Times’s Hamed Aleaziz noted that the staff of CBP’s Donna, Texas processing facility “had a ‘tendency to send migrants to the hospital for things that could easily be treated on location,’ the investigators wrote.” Days earlier, agents refused Anadith Reyes’ parents’ repeated pleas for an ambulance and hospital care.

The August 25, 2023 Washington Post reported that Border Patrol had already decided not to renew a $25 million per month contract with the company providing medical services in its Harlingen, Texas station when Reyes passed there. The agency had not yet selected a company to take over duties performed by Florida-based Loyal Source Government Services, which had filed protests about the contracting process.

Anadith Danay Reyes Alvarez was laid to rest in New Jersey on June 17. “We will let our baby rest and let her rest in peace. We want justice for her so that no one else has to go through this,” read a statement from the family. According to the Associated Press, attorneys with the Texas Civil Rights Project and the Haitian Bridge Alliance have requested an independent autopsy to determine the cause of her death.

— U.S. Customs and Border Protection. “June 1, 2023 Update: Death in Custody of 8-Year-Old in Harlingen, Texas,” June 1, 2023. https://www.cbp.gov/newsroom/speeches-and-statements/june-1-2023-update-death-custody-8-year-old-harlingen-texas.

— U.S. Customs and Border Protection. “Statement from CBP Acting Commissioner Troy Miller on the Investigation of the In-Custody Death of a Child,” June 1, 2023. https://www.cbp.gov/newsroom/speeches-and-statements/statement-cbp-acting-commissioner-troy-miller-investigation.

— U.S. Customs and Border Protection. “Update: Death in Custody of 8-Year-Old in Harlingen, Texas,” May 21, 2023. https://www.cbp.gov/newsroom/speeches-and-statements/update-death-custody-8-year-old-harlingen-texas.

— U.S. Customs and Border Protection. “Statement from CBP Acting Commissioner Troy Miller Regarding the Ongoing Investigation of In-Custody Death,” May 21, 2023. https://www.cbp.gov/newsroom/speeches-and-statements/statement-cbp-acting-commissioner-troy-miller-regarding-ongoing.

— U.S. Customs and Border Protection. “Statement from CBP,” May 17, 2023. https://www.cbp.gov/newsroom/speeches-and-statements/statement-cbp.

— Gonzalez, Valerie. “Mother of 8-Year-Old Girl Who Died in Border Patrol Custody Says Pleas for Hospital Care Were Denied.” Associated Press, May 20, 2023. https://apnews.com/article/border-patrol-custody-death-harlingen-8da5429f39cb7ac0ff4c9184a42d8ba2.

— Garcia, Armando. “CBP Ignored Pleas for Help before Migrant Girl’s Death, Parents Say.” ABC News, June 22, 2023. https://abcnews.go.com/US/cbp-pleas-migrant-girls-death-parents/story?id=100271491.

— Miroff, Nick. “CBP Reassigns Chief Medical Officer after Child’s Death in Border Custody.” Washington Post, June 15, 2023. https://www.washingtonpost.com/nation/2023/06/15/border-patrol-medical-care-child-death/.

— Spagat, Elliot. “Death of 8-Year-Old Girl in Border Patrol Custody Highlights Challenges Providing Medical Care.” AP News, May 22, 2023. https://apnews.com/article/border-patrol-custody-child-death-e6dbfde4986eb9e8a91284c3f80293df.

— Miroff, Nick. “Inquiry after Girl’s Death Reports Unsafe Medical Care in U.S. Border Facilities.” Washington Post, June 22, 2023. https://www.washingtonpost.com/immigration/2023/06/22/medical-care-unsafe-border-facilities-migrants/.

— Aleaziz, Hamed. “Border Patrol Officials Complained of ‘overuse of Hospitalization’ as 8-Year-Old Died.” Los Angeles Times, June 28, 2023. https://www.latimes.com/politics/story/2023-06-28/8-year-old-border-patrol-death-fever-hospital.

— Univision. “Entierran a la niña que murió en custodia de la Patrulla Fronteriza y sus padres aseguran: ‘Buscaremos justicia.’” Univision, June 17, 2023. https://www.univision.com/noticias/inmigracion/padres-nina-8-anos-murio-custodia-patrulla-fronteriza-entierran.

— Gonzalez, Valerie, and Liset Cruz. “Balloons, Tears and Hugs as Family of Girl Who Died in Border Patrol Custody Holds New York Funeral.” AP News, June 16, 2023. https://apnews.com/article/border-patrol-anadith-custody-death-8cfee1e24758eefc21086ff3a2215943.

— Miroff, Nick. “Before Child Died in Custody, CBP Tried to Replace Medical Contractor.” Washington Post, August 28, 2023. https://www.washingtonpost.com/immigration/2023/08/25/border-medical-migrants-loyal-source/.

Sector(s): Rio Grande Valley

Agency(ies): Border Patrol

Event Type(s): Conditions in Custody, Denial of Medical Care, Fatal Encounter

Accountability Status: Shared with DHS OIG, Shared with Local Police, Under OPR Investigation

Victim Classification: Accompanied Child, Family Unit, Female, Panama