The recent shooting of a man by an Immigration and Customs Enforcement officer in Austin has led to questions about hospitals\u2019 legal obligations when treating ICE detainees with traumatic injuries.<\/p>\n
28-year-old Wilber Garces Perez was shot in the back by an ICE officer Sunday. Video shared by the Austin Police Department suggests the shooting followed a car pursuit. Garces Perez and his lawyer have described an unprovoked encounter with authorities, but the Department of Homeland Security said he was the subject of a \u201ctargeted vehicle stop\u201d and attempted to evade arrest.<\/p>\n
After the incident, Garces Perez was taken to Austin\u2019s Dell Seton Medical Center for treatment \u2014 but he and his lawyer have said they do not believe he was given appropriate care at the hospital, and remains in poor condition at a detention center in South Texas with a bullet still lodged in his back.<\/p>\n
Representatives for the hospital and for ICE have disputed the claim that Garces Perez has not received adequate care. But community members and elected officials are still pushing for answers on whether Garces Perez is getting what he needs.<\/p>\n
\u201cI am making it very clear to every part of the federal government that ICE needs to take the medical care of Wilber Garces Perez extremely seriously,\u201d Texas Congressman Greg Casar said at a news conference Wednesday.<\/p>\n
What happened at the hospital in Austin?<\/p>\n
Garces Perez\u2019s lawyer Kate Lincoln-Goldfinch said he was discharged from Dell Seton on Sunday after about four hours there. Lincoln-Goldfinch and Garces Perez\u2019s wife asked for information about his condition at the hospital that afternoon, but they were told by a security guard that he was not there.<\/p>\n
Later, Austin Mayor Kirk Watson arrived and told the women they would hear from a hospital attorney. They learned from the attorney that Garces Perez had already been discharged to an ICE detention center.<\/p>\n
\u201cI’m very displeased and disappointed in the way that the hospital treated him and the way that they treated me and his wife,\u201d Lincoln-Goldfinch said in an interview with KUT. \u201cI don’t think in any circumstance is it adequate care to discharge someone from a hospital four hours after they’ve been shot while they have the bullet still lodged in their body.\u201d<\/p>\n
Watson echoed some of her sentiments in a news conference Tuesday. He said he was \u201cbothered\u201d that Garces Perez\u2019s spouse was not kept informed by hospital staff.<\/p>\n
\u201cAs it applies to the actual medical part of it, I’m not going to judge that,\u201d he said. \u201cIf it were me, I would hope that I would have more than just a few hours in the hospital if I was shot in the back.\u201d<\/p>\n
A spokesperson for Ascension Seton, which owns and operates Dell Seton Medical Center, said the hospital had followed established protocols when treating Garces Perez, but would not offer details on what those protocols are.<\/p>\n
\u201cWe have established procedures and policies related to interactions with law enforcement, which are the same regardless of agency\u2014federal, state or local\u2014that were strictly followed in this case,\u201d the spokesperson said.<\/p>\n
After being discharged, Garces Perez was taken to a detention center in Pearsall, Texas, around 130 miles away. Since then, Garces Perez has said he has limited mobility on one side and only has access to over-the-counter pain relievers, though he was temporarily admitted to another hospital where he received morphine earlier this week.<\/p>\n
A bullet still embedded<\/p>\n
At the press conference Wednesday, Congressman Casar called for transparency into the decision-making surrounding Garces Perez\u2019s care: Why was he released from Dell Seton after just a few hours with a bullet still in his body?<\/p>\n
\u201cI think there also needs to be transparency about what those law enforcement officers did and said to pull somebody out of a hospital while they’re still bleeding,\u201d Casar said.<\/p>\n
Garces Perez has said he was not kept fully informed about his condition by his doctors while at Dell Seton and was told ICE agents were \u201cin a hurry to get you out of here.”<\/p>\n
Under a federal law known as the Emergency Medical Treatment and Labor Act<\/a>, or EMTALA, hospitals and emergency rooms that receive funding from Medicare must provide stabilizing care to all patients who arrive at the facility with an emergency medical condition \u2014 such as a gunshot wound.<\/p>\n Legal and medical experts who spoke to KUT said it was difficult to assess whether Garces Perez had received adequate care without reviewing medical records. However, Dr. Amy Zeidan, an Atlanta-based emergency medicine physician and researcher on emergency care for immigration detainees, said the fact that Garces Perez was discharged without the bullet being removed wasn\u2019t necessarily a red flag.<\/p>\n \u201cI know it seems kind of crazy, but we do discharge people not infrequently with ballistic injuries, including retained bullets,\u201d she said.<\/p>\n A bullet located near the spinal cord, for instance, might not be removed because surgery could result in paralysis or other serious complications, she said. Additionally, a bullet might be removed at a follow-up appointment so a specialist can weigh in on the patient\u2019s options.<\/p>\n As for Garces Perez\u2019s four-hour stay at the hospital, Zeidan said a level I trauma center such as Dell Seton often has the ability to move quickly when treating emergent injuries, though how quickly depends on a number of factors. Lincoln-Goldfinch told KUT this week that Garces Perez is working on requesting his records from Dell Seton to gain more insight into those medical decisions.<\/p>\n Zeidan did say she has encountered situations where ICE agents and other law enforcement personnel have pressured or come into conflict with medical staff. Sometimes, she said, they aren\u2019t familiar with medical laws, like HIPAA, which protects patient privacy.<\/p>\n \u201cMost guards, if I ask them to step out of the room, they will not want to,\u201d Zeidan said. \u201cTheir priority and their duty is they have to keep eyes on the person in custody at all times. But it\u2019s a HIPAA violation if they don\u2019t step out of the room.\u201d<\/p>\n Jennifer Whitlock, a lawyer with the National Immigration Law Center who has helped compile a handbook<\/a> for healthcare workers who are treating patients in immigration custody, said she is worried by Garces Perez\u2019s statements that he was not kept informed of his condition by doctors \u2014 and that his wife was kept in the dark.<\/p>\n \u201cEven when someone’s in ICE detention, they have the right to speak with their family,\u201d she said. \u201cAnd I think in scenarios where a physician would normally call or someone’s incapacitated, then they definitely should be allowed to call a patient’s family member.\u201d<\/p>\n Follow-up care<\/p>\n Zeidan said follow-up care for a ballistic injury is often needed, and she has concerns about the care available at many detention centers. An investigation<\/a> by KFF Health News and The Associated Press this year found evidence of widespread medical neglect at ICE facilities.<\/p>\n \u201cI would be worried about anybody with any medical problems or injuries going to a detention facility,\u201d Zeidan said.<\/p>\n Congressman Casar described seeing Graces Perez\u2019s wound covered in bloody gauze, with black and purple bruises across his chest. He said medical staff at the detention center assured him they were regularly changing the bandages.<\/p>\n Casar said Garces Perez had been able to see a specialist on Wednesday. He was provided with an injection of stronger pain medication and was told that he should have surgery to remove the bullet.<\/p>\n \u201cIf Wilber and his wife decide that he needs to go through with surgery, then ICE needs to expedite his care,\u201d Casar said.<\/p>\n Correction: This story has been updated to correct the name of the Department of Homeland Security.<\/p>\n