How did the ACLU/PHR report determine that 95% of ICE detention deaths were preventable?
Executive summary
The 95% figure — that 95 percent of deaths in ICE detention “could likely have been prevented” — comes from a joint ACLU/Physicians for Human Rights (PHR)/American Oversight report that reviewed 52 deaths in ICE custody from 2017–2021 and applied independent medical expert reviews against accepted standards of care, concluding that clinical failures played a role in nearly all cases analyzed [1] [2]. The report’s finding is grounded in document review (over 14,500 pages obtained through FOIA and public-record requests), expert clinical re-evaluation of ICE’s own investigations, and a catalog of recurrent failures such as delayed or incorrect diagnoses, inadequate emergency response, and mental-health lapses [1] [2] [3].
1. What the researchers actually examined: the cases, documents, and experts
The analysis focused on 52 deaths that ICE reported between January 1, 2017 and December 31, 2021, drawing on more than 14,500 pages of records obtained via FOIA and state requests, copies of ICE’s own death-investigation reports, and interviews with family members; independent medical experts then reviewed those materials to judge whether care fell below clinical standards and whether that failure likely contributed to death [1] [2]. The 95% headline is a synthesis of those expert determinations — not a statistical extrapolation across all ICE custody deaths beyond the reviewed sample — and reflects the proportion of the 52 reviewed deaths judged preventable or possibly preventable through clinically appropriate care [1] [3].
2. How “preventable” was defined and applied
The report used clinical judgments by independent medical reviewers to categorize deaths as preventable/possibly preventable when lapses in assessment, diagnosis, treatment, or emergency response constituted departures from accepted clinical standards and plausibly contributed to the fatal outcome; reviewers compared what happened to what timely, guideline-consistent care would likely have achieved [1] [2]. Concrete signals included late or missed diagnoses, inappropriate medication management, and failure to provide timely emergency interventions — factors that, when present in the files and expert opinions, led to a determination that a death could likely have been averted with adequate care [3] [4].
3. Patterns that produced the high percentage
The report documents systemic patterns: medical staff made incorrect or incomplete diagnoses in 88% of the deaths reviewed and provided delayed or inappropriate treatment in many cases; detention facilities also failed to provide timely emergency care and basic COVID-19 precautions, and mental-health failures contributed to suicides the authors judged preventable with proper care [3] [4]. Those recurring clinical and operational breakdowns across the 52 cases are the proximate basis for the conclusion that the vast majority were preventable [1] [3].
4. Oversight, accountability, and structural context the authors used to support their assessment
Beyond clinical files, the report argues that DHS and ICE investigative processes and accountability mechanisms are flawed — evidence was withheld or destroyed, investigations often omitted key witnesses or structural analysis, and ICE rarely imposed meaningful penalties (the authors found only three financial penalties across dozens of deaths) — a context the authors say indicates systemic risk not isolated clinician error [5] [6] [2].
5. Limits, caveats, and competing perspectives
The finding is limited to the specific cases and documents the authors could obtain; the report relies heavily on ICE’s own reports plus supplemental records and expert interpretation, and the assembled organizations (ACLU, PHR, American Oversight) are advocacy groups pushing for systemic change, which shapes framing and recommendations [1] [7] [3]. The provided sources do not include a detailed ICE rebuttal to the methodology or a public accounting from ICE disputing the expert re-assessments, so independent confirmation beyond the report’s expert reviews is not visible in the materials reviewed here [1] [2].
6. Bottom line
The 95% figure is the product of case-by-case clinical re-evaluations by independent experts applied to a documented set of 52 deaths, combined with a pattern analysis of recurring failures in assessment, diagnosis, treatment, emergency response, and oversight; those combined judgments led the authors to conclude that clinically appropriate care would likely have prevented nearly all the deaths they examined [1] [3] [2]. The conclusion is persuasive within the report’s evidentiary frame but remains bounded by its sample, sources, and the absence of a documented counter-analysis from ICE in the materials provided [1] [5].