Reforming Immigration Detention Health Care Standards through the Courts: The Legacy of Francisco Castaneda
By Adele Kimmel, Public Justice Managing Attorney
Our federal government has begun overhauling its health care system for immigrant detainees. What finally spurred the change? Attorneys in the trenches, using our civil justice system to fight for mistreated detainees. It was the battles in the courts that won these reforms, not the battles in Congress. As proposed legislative reforms stalled, lawsuits succeeded in forcing our government to take responsibility for its past failures and make changes to avoid repeating the same mistakes in the future.
One major impetus for change was Public Justice’s lawsuits over the medical neglect, penile amputation, and death of Salvadoran national Francisco Castaneda. Mr. Castaneda’s tragic illness and death revealed gross negligence and heartbreaking indifference by the government officials charged with his care. It also shined a spotlight on a badly broken system in desperate need of reform.
Earlier this month, the United States agreed to pay $1.95 million to the family of Francisco Castaneda, who died of penile cancer that federal officials had refused to diagnose and treat during his nearly 11 months in immigration detention. After his release, Mr. Castaneda had his penis amputated to try to keep the cancer from spreading, but it was too late. He died in February 2008 at age 36.
The United States’ payment settled a federal lawsuit alleging that Mr. Castaneda had died as a result of the government’s negligence, both in its medical care and in its creation of a woefully deficient health care policy for immigrant detainees. The lawsuit—filed by Public Justice in November 2007— had been scheduled for trial beginning on April 26.
The federal district court in Los Angeles approved the settlement in Castaneda v. United States on April 21.
Although the United States had admitted in 2008 that its negligence had caused Mr. Castaneda’s death, it took another two-and-a-half years of litigation—in two lawsuits—to make its admission meaningful. Public Justice litigated the federal case up to the U.S. Supreme Court and back to the trial court in that time frame.
In addition, in a separate lawsuit that Public Justice had filed against the State of California, a Los Angeles jury awarded the Castaneda family $1.73 million in November 2010 for the state’s role in causing Mr. Castaneda’s death. Mr. Castaneda had been in the state’s custody for four months before being transferred to immigration detention, and state officials had similarly failed to provide Mr. Castaneda with the immediate medical care they knew he needed for his penile lesion.
As a result of both cases, Mr. Castaneda’s tragic story was told in newspapers and on TV news programs all over the world. His story became the poster child of what government health providers should not do when caring for immigration detainees.
In response to Mr. Castaneda’s lawsuit, and a class action on behalf of detainees at the San Diego Correctional Facility where Mr. Castaneda had been held, the United States agreed to change the deficient health care policies highlighted in both cases. Indeed, the federal government scrapped the old system and replaced it with a new program called MedPar, which can be found on Immigration and Customs Enforcement’s web site: http://www.inshealth.org.
Under the new policy, detainees will get care for serious medical needs—including urgent needs—rather than having to languish until their needs turn into an emergency in which they are literally on the verge of death. In addition, detainees’ medical treatment will no longer be tied to their length of incarceration and “deportation status.” Instead, they will simply be treated based on the seriousness of their medical needs, in accordance with basic constitutional standards that apply in a custodial setting.
Moreover, on-site medical providers will now have the authority to make care decisions for detainees with urgent, but not immediately life-threatening, needs. No longer will on-site medical providers have to wait for a requested diagnostic test or treatment to get approved by a bureaucrat in Washington, D.C., who has never even seen the patient.
Though long overdue, these changes to the detainee health care system are certainly welcome. And they were brought about in large part by a courageous Salvadoran immigrant willing to tell his painful, very personal story and fight for justice in the courts, with the help of attorneys who work to keep the courthouse doors open for all who are wronged.
Public Justice’s lawsuits on behalf of the Castaneda family were a team effort by my co-lead counsel, Public Justice Foundation Board member Conal Doyle of Willoughby Doyle in Beverly Hills; Public Justice Foundation Past President and Board member Thomas Dempsey of Beverly Hills; and Public Justice Goldberg Attorney Amy Radon. But our real leaders in this effort were Francisco Castaneda and the family members who carried on the battle after his death—his daughter, Vanessa and his sister, Yanira.
Although Francisco Castaneda filed his lawsuits to get justice for his family, his main goal was to effect change so that no other detainee would suffer in the way he did. His family is taking some comfort in knowing that his ordeal has made a difference. The government’s recent changes to its detainee health care system are Francisco Castaneda’s legacy.
About the Author
Adele P. Kimmel is the Managing Attorney at the D.C. headquarters of Public Justice. She has served as counsel in a wide variety of precedent-setting cases, with a particular emphasis on civil rights issues. Adele is co-lead counsel for the Castaneda family.