Comment by Carolyn E. Young
Yanira Yesenia Oldaker remembers the cold, sterile examination room, the sharp pain of a transvaginal ultrasound, and the confusion when she underwent an unnecessary pap smear despite already having undergone a hysterectomy. Karina Cisneros Perciado, “a 23-year-old mother and survivor of domestic abuse,” sought postpartum care while detained. Instead of receiving routine medical attention, medical personnel subjected her to a vaginal ultrasound under the guise of a pap smear. Then, while handcuffed, they gave her a Depo-Provera injection without explanation. Jaromy Floriano Navarro, a twenty-nine-year-old mother of three, described Irwin County Detention Center (ICDC) as “living in Hell” after she narrowly avoided a hysterectomy she did not understand or consent to. Staff pressured her, claiming the United States Immigration and Customs Enforcement (ICE) had “already paid for” the procedure. Wendy Dowe, “a 51-year-old mother of four,” endured shackles during a surgery she had never agreed to, only to wake up in pain with no explanation of what had occurred. Despite her repeated requests to ICDC staff for a second opinion on a suggested hysterectomy, staff consistently referred Dowe back to Dr. Mahendra Amin, who claimed she had a cancerous tumor requiring immediate surgery. After ICE deported her to Jamaica, another doctor informed her that the tumor did not exist.
In September 2020, the Project South Institute for the Elimination of Poverty and Genocide (Project South) released a whistleblower report based on allegations from Dawn Wooten, a nurse at ICDC, alleging that immigrant detainees had undergone troubling medical practices, including coercive hysterectomies. The report included claims of shredding medical requests, fabricating records, and performing invasive gynecological procedures without informed consent, all of which were exacerbated by language barriers and coercive tactics. These allegations prompted the United States Senate Permanent Subcommittee on Investigations to investigate. The subcommittee’s May 2021 report substantiated many of the whistleblowers’ claims of significant medical abuse at ICDC. Although the report did not confirm mass hysterectomies, it documented that Dr. Mahendra Amin performed a disproportionately large number of invasive and unnecessary gynecological procedures compared to other health care providers serving the rest of the nation’s immigration detention centers.
In Oldaker v. Giles, sixteen former ICDC detainees filed a classaction lawsuit in the United States District Court for the Middle District of Georgia. The claims against the ICDC defendants focused on LaSalle Southeast, LLC’s (LaSalle) mismanagement of ICDC and the negligent or intentional conduct of facility staff. However, the claims against ICDC defendants, including Dr. Amin and LaSalle, were ultimately dismissed. The court rejected claims under 42 U.S.C. § 1983, finding that LaSalle, its employees, and Dr. Amin were not acting under color of state law. Likewise, Bivens claims against these parties as federal actors also failed, leaving plaintiffs without a viable remedy for the extensive harm they suffered. This lack of accountability highlights a critical oversight in the legal framework governing immigration detention facilities.
The case of Oldaker v. Giles exemplifies the failure of the legal system to adequately address the structural realities of immigration detention. While the actions of Dr. Amin are central to the events at the ICDC, focusing solely on his misconduct risks oversimplifying a much larger issue. Immigration detention in the United States currently operates under a complex web of federal, state, and private actors. At the core of this system are Intergovernmental Service Agreements (IGSAs), in which local governments act as intermediaries between ICE and private contractors, such as LaSalle. The financial and operational delegation between ICE, local governments, and private contractors creates a chain of responsibility that should not, but has operated to, absolve private entities from constitutional scrutiny. This gap in oversight creates a significant liability loophole where both federal and state governments benefit from the arrangement while avoiding liability for any constitutional violations committed by the private actor. Within existing case law, “[t]here is no set formula for determining” whether individuals within a joint federal-state program acted under the color of state law. When local governments serve as the primary contractors in IGSA arrangements, they effectively create a legal mechanism that should allow detained individuals to hold private detention center operators accountable as state actors under § 1983.
This Comment addresses the legal and structural issues surrounding immigration detention under IGSAs, focusing on the role of private contractors and the accountability gaps created by these arrangements. Despite the assumption that immigration detention falls solely within federal authority, IGSA facilities operate within a system of cooperative federalism where local governments actively participate in and benefit from detention contracts. As a result, private subcontractors should be subject to liability under § 1983 to prevent government actors from outsourcing detention responsibilities while escaping responsibility for constitutional violations. Part II examines the evolution of IGSAs as the primary mechanism through which ICE delegates detention operations to private entities, tracing their historical roots, expansion through local government participation, and the economic and political incentives that drive state and local governments to engage as intermediaries. Part III explores how the structure of IGSAs creates perverse incentives that prioritize profits over detainee welfare, using the ICDC as a case study to show systemic oversight failures in detainee health care. Part IV analyzes the legal barriers immigrant detainees face in seeking constitutional remedies, focusing on Oldaker v. Giles, where the court rejected § 1983 and Bivens claims. Part V assesses the elements of § 1983 and how private actors may qualify as state actors for purposes of § 1983 liability. Part VI argues that courts should recognize private contractors operating under IGSAs as state actors under § 1983 to ensure constitutional accountability. It demonstrates that IGSAs complicate the federal-state divide in immigration enforcement and critiques the Oldaker court’s narrow interpretation of state action, contending that IGSA facilities operate within a framework of cooperative federalism. Part VII briefly concludes.
About the Author
Carolyn “Elle” Young, J.D. 2026, Tulane University Law School; B.S. 2023, Washington and Lee University.
Citation
100 Tul. L. Rev. Online 1 (2026) 1