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Francisco Castaneda came to the United States from El Salvador during its civil war of the 1980s. Fleeing the violence, his mother crossed the U.S.-Mexico border illegally in 1982 with Francisco, aged 10, and his three siblings. Her husband had died of a heart attack just before they left. For years, she did odd jobs and sewing in and around Los Angeles. But she died of cancer before turning 40 and before she secured legal status for her children.

After her death, Castaneda, by then in his late teens, was on his own. For a time he had a work permit and did construction. But then he got involved in drugs. In 2005, he was convicted of methamphetamine possession with intent to sell, a felony, and was sent to prison for three and a half months. Upon his release, federal authorities immediately detained him as an illegal immigrant. Pending deportation, he was transferred to a detention center in San Diego operated under the auspices of Immigration and Customs Enforcement, an agency newly organized under the Department of Homeland Security.

The agency's acronym, ICE, a rare instance of bureaucratic humor, has stuck. According to its website, ICE "investigates a wide range of domestic and international activities arising from the movement of people and goods that violate immigration and customs laws and threaten national security." Immigration and Customs Enforcement is the largest investigative agency in the Department of Homeland Security. In 300 facilities, both detention centers and jails, the government processes more than 300,000 detainees — men, women, and children — every year. One of the agency’s five divisions, the Office of Detention and Removal Operations, “is responsible for promoting public safety and national security by ensuring the departure of all removable aliens from the United States through the fair enforcement of the nation’s immigration laws.” The agency is required to detain immigrants in humane conditions, their “departure” just and swift.

While in prison, Castaneda had noticed a sore on his penis and pain in his groin. His back and kidneys were also hurting. He filled out the requisite health-care request forms and was examined at the prison’s “wart clinic.” There, a Department of Corrections medical provider, a man believed to be “S. Pasha,” found “a 2 cm x 2 cm raised white and yellow lesion on his foreskin.” He prescribed antibiotics and ordered an “urgent urological referral,” but Castaneda never received either.

Castaneda was taken to the San Diego Correctional Facility on Otay Mesa in March 2006. The minimum-medium–security lockup, whose population was 1000 when Castaneda arrived, holds detainees while their cases are reviewed; some stay for weeks, some for years. The facility is leased from the County of San Diego by the publicly traded Corrections Corporation of America, which owns or operates 66 prisons and detention centers. (In the wake of September 11, the Corrections Corporation of America received a boon in new contracts. In 2000, the company was nearly bankrupt while last year its revenue topped $1.4 billion.) When ICE contracts with private prisons, the agency guarantees “fair enforcement” of immigration laws, including inmate access to health care. In 2002, the Corrections Corporation of America was relieved of its contract to provide health care at the San Diego Correctional Facility; at the time, a federal medical director found the corporation had decreased its services severely. He returned the job to the Public Health Services’ Division of Immigration Health Services, which, in an ironic twist, outsources some of its care, sending detainees to private doctors.

At the Otay Mesa facility, Castaneda complained, according to court records, that “a lesion on his penis was becoming painful, growing in size, and exuding discharge.” He ranked the pain during urination and erection an eight out of ten. The suppurating wound had a “foul odor,” a necrotic smell, the death of living tissue. The lesion was “now draining pus” and was “more macerated at the glans,” or penis head. Lieutenant Anthony Walker, a physician’s assistant employed by the Division of Immigration Health Services, examined him and requested a “urology consult” as soon as possible — and a biopsy, which he termed “a pertinent surgical” follow-up.

Castaneda told Walker that he was worried about the growth because his mother had died of pancreatic cancer at age 39. Walker, who stated later that he was not sure “what the lesion would present, if and when the biopsy was completed,” realized it was best to “rule out penile cancer — the sooner the better.” (A biopsy was the only way to do that.) Walker drained and cleaned the lesion, but within a few days the pus was back.

Castaneda was getting ibuprofen. At times, he would show his bloodied underpants to guards. They said they couldn’t help his medical condition but would bring him clean bedsheets. One guard told Castaneda that he would pray for him because he could see how much he was suffering.

Two and a half months after the initial diagnosis, Castaneda saw Dr. John Wilkinson, an outside oncologist. His recommendation was unequivocal: “I strongly agree that” the lesion “requires urgent urologic assessment of biopsy and definitive treatment.” He wrote that from even “benign lesions” there can be “considerable morbidity.” Castaneda should also have his foreskin circumcised, Wilkinson wrote, adding that everyone understood “the need for urgent…treatment.”

Enter Dr. Esther Yun-Hung Hui, the clinical director at the Otay Mesa facility and the only onsite physician for the facility’s 1000 detainees. After assessing Castaneda’s case, she wrote that the Division of Immigration Health Services rated a biopsy as an “elective outpatient procedure.” Her recommendation was “to pursue outpatient biopsy that would be more cost effective.” The upshot was, Castaneda received nothing except more pills.

Castaneda filed a grievance, citing Wilkinson’s recommendation, but the grievance was denied. A day later, health services personnel documented that Castaneda’s penis was “getting worse, more swelling to the area, foul odor, drainage, more difficult to urinate, bleeding from the foreskin.” The record also expressed the opinion that he did “not have cancer at this time,” as he had not had a biopsy diagnosing cancer. He was advised “to be patient and wait.”

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JacKim Dec. 10, 2008 @ 10:54 p.m.

I am just speechless. Had Castenada been a dog in the pound, he'd have gotten much faster and more humane treatment before dying an excruciating and needless death. I hope his daughter wins the case. Although it will not bring her father back, it will be ONE MORE nail in California's Prison Coffin. Sadly, there are many "Castenada's" in our California prisons. For those of you who wonder "why" our prisons are under Receivership, this case alone should answer that question. It has been found that one inmate dies needlessly or from negligence and medical incompetence every 6 days in our prisons. It is also reported that (at least) one inmate suicide per week occurs. I feel like ranting and raving and quoting study after study after report after report, but I won't. Let me just ask - where has our humanity gone? We pass laws to protect chickens - CHICKENS THAT WE ARE GOING TO KILL TO EAT ANYWAY! - yet "We the People" (yes, VOTERS - WE) allow this rampant and unspeakable type of horror to thrive in our prisons. This story makes me not just ashamed to be a Californian, it makes me ashamed to be human.


Keith_Richard_Radford_Jr Dec. 11, 2008 @ 3:15 a.m.

As for passing laws for chickens by: Keith Richard Radford Jr

Chickens have not won in the request on their behalf by speakers for the silent fowl by foul lawmakers pushing agendas. The fact is that by changing the law for chickens space the adjustment effects the space an inmate has available to live in. Now many law suite have been set aside and people can be packed tighter for more revenue for them revenuers.

Speeking of tax dollars and the flimflam man, when voting on one side of an issue and it is all you see look closer cuz, cuse reading chicken lips is not possible, they have NoNe!


dunitdevotroedell Dec. 11, 2008 @ 8:54 p.m.

I am sorry to say but I once worked at Corrections Corporation Of America in Otay Mesa. It was time someone exposed these inhumanities. What this article has stated is fact! 100 percent accurate. I understand inmates and detainees have broken the law but in that facility only 10 percent of those housed there are level III inmates, the majority are illegal aliens. These inmates have been violated to such extreme that I believe this facility should be closed and their ICE & USM contract revoked. Corrections Corporation of America is just there for the money. The lack of qualified officers and staff at that facility is lacking. Half if not more of the Detention Officers could not pass a Psychological evaluation. They are not even required to have a CORE Certification by the state of California, all they are require to have is a California Guard Card a monkey can get that. How can you be a first responder to an emergency if you do not have adequate training. There goes our tax dlls. As to the Castaneda Family my deepest apologies his death was not necessary nor warrented at least here in the United States


blue Dec. 11, 2008 @ 9 p.m.

WOW!!!!!!!! that was a TRUELY biased rendition. but it is too common to point a finger and to find a culprit to blame for an otherwise unfortunate part of reality. PEOPLE GET SICK, PEOPLE DIE. Lack of health care, because of a positive financial situations or status in life is an everyday problem. Rich and prominent people have better healthcare and options than those less fortunate. Unfortunately people in jail are on the bottom of this totem pole. Not the very bottom however. At least there IS a 90+ MILLION dollar budget for them. What about our own law abiding, working class, but not insured citizens that cant even walk into a hospital without the badgering of an insurance card or no service. While it absolutely SUCKs about Mr. Castenada, this is happening all day everyday to our American families. WHO do u point the finger to there? WHAT do YOU do besides shake your head and look for someone ELSE to blame. this was just more self righteous propaganda!


JacKim Dec. 11, 2008 @ 10:45 p.m.

Blue - based on your comments I can only guess that you did not read the entire article. And to clear up any misunderstanding you have about receiving health care: ANYONE, regardless of income, can walk into an emergency room and get immediate attention, whether they have insurance or not. A public hospital, BY LAW, can't turn anyone away. PERIOD. Mr. Castaneda continued to be denied proper and timely medical attention, and since he was in custody he didn't have the ability to "just go to the nearest ER".

I agree with you that health insurance is not something we all have and it's a problem for many. But we do have programs such as Medi-Cal, Medi-Care and Healthy Families for the truly desperate or needy. There are also insurance programs for the self-employed as well as programs that an individual can pay for themselves if they make too much money to qualify for either full Medi-Cal benefits, or co-pay Medi-Cal. But again, ANYONE (not in a prison or jail) can go to a public hospital's ER and get immediate medical attention.


Fred Williams Dec. 12, 2008 @ 7:14 a.m.

Blue, in addition to what JacKim wrote, you should me mindful that this was a case that amounted to death through torture and neglect.

How would you react to growing a tumorous mass on your genitals. Jabs of pain when you try to walk, going without liquids to avoid the razor blades ripping out your urethra when you pee. The daily horror of waking up to torn skin and blood soaking your underwear. It spreads to your rectum, you can feel the mass under your skin, growing larger and more painful as you sit in your cell, waiting and hoping they'll do something to help you.

Even the guard-card prison staff feels pity for you, wincing in sympathy as they see you groaning in pain. All they can give you is a few ibuprofin. They write in the log, day after day, describing your horrible symptoms, and it just gets worse.

Blue, do you think that is acceptable?

Yes, many of us have no health insurance. But at least we can stumble to a hospital and expect that they'll at the minimum attempt to do something about a situation as dire as what this man endured, month after month.

The prison choose to turn a blind eye to an unmistakable tragedy happening right before them. They allowed the torture to go on. And on. And on. In prison, where there is no escape.

Then, when he was past any hope of recovery, they dumped him on the street.

Blue, this does NOT happen every day to American families.

People DO get sick, yes. But they do not have to DIE...especially when it's detected and treated early. Castaneda DID detect it early. He tried his hardest to get any kind of treatment, and it was denied to him.


Was it scorn? "Hee, hee. Dude's got something growing on his dick. How funny!"

Was it prejudice? "Screw em. Wet backs in prison deserve what's coming to them."

Sorry, Blue. There's no reasonable excuse, no equivication, and no argument to be made that this is somehow normal or acceptable. When you imprison someone, you take responsibility for their care in detention.

Imprisoning someone and then allowing them to die is negligent homicide, manslaughter in the 2nd degree. Bringing this story to the attention of the public isn't propaganda, it's important journalism and one of our few safeguards against official abuse.

Now let's hope the doctors and officials who allowed this man to die through neglect are held accountable.


JohnnyVegas Dec. 12, 2008 @ 12:38 p.m.

This case is still in court being litigated (it is a very well known case) and I have a feeling when it is over there will be a judgment in the 8 figure range-and there will be no accountability in governent, zero, none, nada, for those responsible.


Sarcasm Dec. 16, 2008 @ 4:13 p.m.

I truly am sorry for the plight of Francisco Castaneda, however, HE himself is responsible for the decisions that put him in this situation. I'm sure all the bleeding heart posters here don't stop and consider the MANY legal citizens who were denied medical care in areas where illegals broke the system to the point where hospitals closed and medical aid was no longer available. Too bad - I hope the long-suffering tax payers don't get hit in the pocketbook for Francisco Castaneda, once again.


babyblueye2142 Dec. 17, 2008 @ 10:01 a.m.

This case is very dificult. For one it does not matter what country a person is from! This is the United States of America the land of the FREE! NOT everyone can just walk into an ER and get immediate services. Before it is all sent into the prison or jail system, if you look at the "crime" itelf. if one is committed. If you are a suspect in any crime and you stroll into an ER they cannot touch you until the police show up and clear you. EMS rolls up on a scene before the police, they cannot treat you or even leave their vehicle until the police come to clear the scene. You could be shot and bleeding to death but the police do not come for 20-40 minutes later but the ambulance was there 5 minutes after the call. Is that considered neglect?? What about if you are an EMT or firefighter, paid or not if you witness an accident you are technically not allowed to leave the scene of that incident until cleared by police. If you do leave the scene before cleared and the victim dies, you can be charged with their death. I personally would not want that on my consience, sitting in the ambulance waiting for the police to show up while a person dies in front of my eyes.. I would much rather lose my job.

As for Castaneda's case, they could have passed it off at first but as it got worse, they should have taken the proper measures to take care of it. They thought with all the deaths and money they were saving by letting them all suffer then release them... well they thought they were coverin their oen arse.. GREEDY, GREEDY,GREEDY what would that mean if they spent a few million on health care?They would have less funds, but what did the funds go for anyhow? They were housing 3 people in a cell so it wasn't for construction of new cells.... Then I think the topper to this one is they had people wash the medical records clean, that tells you right there they KNEW they were guilty and proceeded through with it anyway. Must have paid that person off with the money they were saving huh?? I think that someone should come through and look through all the guards reports of observations unless they weren't even writing it down... this whole thing just sickens me. Anyone who has even had a wisdom tooth bother them knows that is makes the whole side of your face hurt from tour jaw to your ear to your head... Can you imagine having that pain CONTINUOSLY for MONTHS before getting it even looked at. After you take a medicine for so long your body becomes immune to it so it does not work anymore... How would that pain feel EVERYDAY ALL DAY??? That is just from a TOOTH!!!!! I cannot even imagine what Castaneda went through. I know it will not bring her father back but they took her father away and I hope they set Vanessa up financially for LIFE!!!


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