Migrant mother requested aid three times the day her 8-year-old daughter died in U.S. border custody

Washington — The mother of a young migrant girl who died in U.S. Border Patrol custody last week requested medical aid at least three times the day her sick daughter was pronounced dead at a Texas hospital, government officials said Sunday.

Eight-year-old Anadith Tanay Reyes Alvarez, who was born with a heart condition, died on May 17 after experiencing a medical emergency inside a Border Patrol station in Harlingen, Texas. A local medical examiner is still probing the death, but an initial autopsy referenced Reyes Alvarez’s heart disease and sickle cell anemia, officials said.

Reyes Alvarez was detained in Border Patrol facilities with her parents and siblings for over a week, despite internal rules that instruct agents to hold migrants for no longer than three days. Border Patrol agents can release migrants pending a court hearing or an asylum interview, deport them or transfer them to another agency, such as Immigration and Customs Enforcement (ICE).

In an updated statement Sunday, Customs and Border Protection (CBP), Border Patrol’s parent agency, said agents first processed Reyes Alvarez and her family on May 9. The family remained in the agency’s custody for eight days.

It’s unclear why Reyes Alvarez and her family remained in Border Patrol custody beyond the 72-hour limit. But earlier this month, the agency struggled to house thousands of migrants stuck in detention facilities after border arrivals soared to 10,000 per day shortly before the expiration of Title 42 pandemic-era restrictions on migration. Unlawful crossings along the southern border have since plummeted.

Representatives for CBP did not answer several questions about how the family was processed, including the reason for their prolonged detention. CBP’s Office of Professional Responsibility, which issued Sunday’s statement, is investigating the girl’s death.

In a separate statement Sunday, acting CBP Commissioner Troy Miller said the results of the internal probe into Reyes Alvarez’s death would be made public. Miller also announced he had ordered officials to ensure that medically vulnerable migrants were spending only a “limited” time in Border Patrol facilities and that medical contractors were providing “appropriate care” to those in custody.

“The health and safety of individuals in our custody, our workforce, and communities we serve is paramount,” Miller said. “To that end, we must ensure that medically fragile individuals receive the best possible care and spend the minimum amount of time possible in CBP custody.”

While the Office of Professional Responsibility’s statement left many questions unanswered, it provided the first official timeline of what led up to Reyes Alvarez’s death.

According to the statement, Reyes Alvarez, her family and dozens of other migrants were apprehended by Border Patrol agents near Brownsville, Texas, on the night of May 9. The family was initially taken to an outdoors processing area, where they spent the night before being transported to a tent holding facility in Donna, Texas, the following day, officials said.

Reyes Alvarez, officials added, was medically screened at the Donna facility and “did not complain of any acute illnesses or injuries.” The parents did tell officials about the girls’ heart condition and sickle cell anemia, the statement said.

According to the CBP statement, Reyes Alvarez started complaining about “abdominal pain, nasal congestion, and cough” as early as the afternoon of May 14. After recording a temperature of 101.8 and testing positive for influenza A, Reyes Alvarez was provided several medications, including Tamiflu, officials said. Medical contractors also learned Reyes Alvarez had undergone heart surgery when she was five, the statement said.

CBP said Reyes Alvarez and her family were relocated to the Border Patrol station in Harlingen, which it noted houses migrants “diagnosed with or closely exposed to communicable diseases.” After arriving there on the night of May 12, Reyes Alvarez was again medically screened, officials said. During the following three days, CBP said, Reyes Alvarez received Tamiflu and ibuprofen.

According to CBP, the situation deteriorated on May 17. “At this time, CBP can confirm that medical records documented that the eight-year-old girl and her mother came to the (Harlingen station) medical unit at least three times on Wednesday, May 17, 2023,” the agency said.

Reyes Alvarez was given Zofran — a medication used to prevent nausea and vomiting — and “instructed to hydrate and return if needed” after her first visit, during which she reported vomiting, officials said. Reyes Alvarez then complained of a stomach ache, but medical contractors instructed the mother to follow up again, saying the girl was “stable.” 

At 1:55 p.m., Reyes Alvarez’s mother came back carrying the child, who CBP said “appeared to be having a seizure” and was later unresponsive. Medical contractors called an ambulance and administered CPR, officials added.

The ambulance arrived at 2:07 PM and transported Reyes Alvarez and her mother to the Valley Baptist Medical Center in Harlingen. Fewer than 50 minutes later, Reyes Alvarez was pronounced dead at the hospital.

“Initial findings from the autopsy, which were shared with CBP OPR, indicated an absence of gross physical trauma, the presence of pleural effusions within the chest cavity, mentioned evidence that had been observed of the attempted surgical repair of the girl’s aortic stenosis, and also referenced the provided history of sickle cell anemia,” CBP said.

Reyes Alvarez’s mother told The Associated Press that officials at the Border Patrol facilities ignored earlier calls to hospitalize her daughter. 

“They killed my daughter, because she was nearly a day and a half without being able to breathe,” the mother said, according to AP. “She cried and begged for her life and they ignored her. They didn’t do anything for her.”

In addition to Reyes Alvarez and her family’s week-long detention appearing to violate CBP’s detention policy, it is also unclear whether the processing of the family complies with a 2022 legal agreement that CBP forged with lawyers representing migrant children in a landmark court settlement known as the Flores Agreement, which provides basic rights to minors in U.S. immigration custody. 

The 2022 agreement requires Border Patrol agents in El Paso and south Texas to conduct “enhanced medical monitoring” of migrant children if they are held beyond 72 hours. This includes constant medical checks, at least every 4 hours.

“Between this settlement, and their own internal policies which acknowledge that 72 hours should be the maximum time in custody, it is extraordinarily difficult to understand how this tragedy occurred. Ultimately, Anadith’s death is a reflection of our dehumanizing and dangerous immigration system,” said Neha Desai, the senior director of immigration at the National Center for Youth Law, which represents children in Flores cases.

While Reyes Alvarez was born in Panama, her parents and siblings are from Honduras. The family has since been released from U.S. custody pending the adjudication of their immigration cases.

Honduran government officials and Democratic lawmakers in Congress have all demanded a “thorough” investigation into Reyes Alvarez’s death.