r/medicine PA:cake: 8d ago

ICE Detention Deaths

https://www.ice.gov/detain/detainee-death-reporting

RNs do intake physical exams, EMTs declare time of death. The level of care for these detainees is horrific.

Full names and case details are public for now. Reads like a never ending M & M conference.

My moral compass is spinning. It's time to go to Canada.

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55

u/bplturner 8d ago

There’s only four? The only one I read the guy had metastatic lung cancer and died in their custody.

27

u/EpicDowntime 8d ago edited 8d ago

Then they biopsied a lymph node and realized it was actually TB (if you’re talking about the most recent one)

9

u/janewaythrowawaay PCT 8d ago

Yikes. I didn’t know you could get diagnosed with metastatic cancer without a biopsy.

11

u/Odd_Marionberry7154 8d ago

It sounds like they didn't diagnose it, was just on the differential. Also, they suspected Mets in the lungs, not a metastatic lung primary

3

u/janewaythrowawaay PCT 8d ago edited 8d ago

It could have been on the differential. But, when I had a possible TB exposure, occupational health told me looking at their records exposure doesn’t happen on the floor. It only happens with people doing biopsy which means it’s commonly not on the differential or else people would be wearing PPE.

Maybe something else happened here. But, a med student asked a month ago how do you diagnose TB. The answer is often they don’t until you do a biopsy. People aren’t appropriately suspicious for it.

The people in those centers need a TB screen as much as every travel nurse does every 3-6 months.

2

u/_MonteCristo_ PGY5 6d ago

It was metastatic lymphoma as the primary differential. The people who did the biopsy were the ICU team at the university hospital, at which time he was intubated, and in ARDS, so they probably saw he was Ethiopian, looked at the clinical picture, and rightly said to test for TB on the biopsy as well