The 911 call came two days after immigration agents detained the 23-year-old Guatemalan woman in Minnesota as she was driving her mother and two young siblings to their jobs cleaning houses.
“Excruciating pain,” the employee at the El Paso immigrant detention facility reported.
Emergency responders rushed Andrea Pedro Francisco to the hospital from Camp East Montana on Feb. 7 — just four days before she had been scheduled to receive surgery to remove an ovarian cyst about the size of a lime that had caused her months of intense abdominal pain.
Physicians discharged Pedro Francisco back to the Camp East Montana detention facility with written warnings that if she experienced certain symptoms, including pain in her back, hip, stomach or while urinating, that she should urgently obtain critical care.
Yet in the four months that followed, Immigration and Customs Enforcement officials repeatedly denied Pedro Francisco surgery — or even outside medical opinion to confirm that she does not need it. Pedro Francisco has continued to suffer from excruciating pain, but has primarily been treated with over-the-counter medication such as Ibuprofen to manage her pain.
By contrast, eight OB-GYNs and an emergency physician who specializes in detainee care reviewed 200 pages of Pedro Fancisco’s medical records shared with The Texas Tribune and agreed that she is at “high risk” for a medical emergency and urgently requires surgery. The experts said that her treatment in ICE detention amounts to medical malpractice because it fails to provide the industry’s standard of care and contradicts what external doctors recommended.
If Pedro Francisco does not have that operation, experts warn that she could lose the ability to have children or suffer from other serious health complications. The doctors also said the cyst needs to be screened for cancer. Ovarian cancer, dubbed the “silent killer” because its symptoms can be hard to diagnose, is the fifth-leading cause of cancer among women, spurring more than 15,000 deaths annually.
“It is my medical opinion that Ms. Pedro Francisco will suffer irreparable harm if this treatment is not provided promptly,” wrote Dr. Louis Monnig, a Louisiana OB-GYN at Ochsner Health, a nonprofit health system, in a legal petition demanding her release.
Leticia Zamarripa, a spokesperson for ICE, said in a statement that medical staff determined Pedro Francisco’s condition “does not make her a candidate for surgical intervention,” although they recommended a “periodic” ultrasound.
“ICE maintains longstanding practices to provide comprehensive medical care, including access to vaccines, medical, dental, and mental health services, as well as medical appointments and 24-hour emergency care,” wrote Zamarripa, who declined to answer detailed questions. “This is the best healthcare that many individuals have received in their lives.”
As President Donald Trump has ramped up deportation efforts, Pedro Francisco is one of more than 60,000 people in ICE detention as the administration continues to pursue mass ICE warehouses in its push for expanded removals. Like her, the majority were arrested in the interior of the country and have no criminal convictions. At least 18 people have died in ICE custody this year, nearly a third of them in Texas. That record-breaking number is on pace to surpass the nearly three dozen deaths in 2025, which were the most ICE fatalities in more than two decades.
Experts say this is the result of the administration’s push to detain a far greater number of immigrants than some ICE facilities have capacity for while contracting with companies that either have problematic records or little experience in detention management. At the same time, many medical providers which work with ICE have been unpaid since the fall in a bureaucratic change made by the administration as it switched billing methods.
“Illness and death are the predictable consequences of keeping people in this system that has expanded so rapidly, using unproven contractors, without paying bills and firing staff tasked to oversee violations” at the Department of Homeland Security, said Scott Shuchart, an ICE official under former President Joe Biden and senior adviser during Trump’s first term to the department’s Office of Civil Rights and Civil Liberties, which investigates abuses.
Efforts to obtain Pedro Francisco’s release or treatment outside of ICE have so far failed. A federal judge denied emergency petitions. ICE rejected her humanitarian parole, although another claim is pending. And unlike in Trump’s first term and previous administrations, when detained immigrants could be released on bond, this administration has fought that avenue in the courts. A ruling this spring by the U.S. Court of Appeals for the Fifth Circuit, which oversees Texas, Louisiana and Mississippi, ended that option for most immigrants.
Pedro Francisco’s cause has captured international attention with human rights groups such as Amnesty International calling for her release. Minnesota and Texas congressional representatives who have visited with her also appealed to ICE. Her next immigration court hearing is May 20. Her lawyers fear that the judge could order her deported without a full hearing using a procedural tool known as “pretermission,” which allows judges to deny asylum claims without hearing testimony.
Asra Syed, one of Pedro Francisco’s lawyers, said the administration is denying Pedro Francisco legal recourse while “every day Andrea and a chorus of people that are advocating on her behalf are screaming for basic medical care and it’s still being ignored.”
Gaslit
A few weeks before she was detained, Pedro Francisco went to the hospital in January where she told doctors that she had a history of an ovarian cyst. She described chronic pain “for a year or more” that had recently worsened, according to her medical records.
Physicians prescribed her strong painkillers such as morphine and oxycodone. Her surgery was scheduled for the following month, which would be thwarted by her ICE detention.
In multiple grainy video interviews with the Tribune from two ICE facilities over the past two months, Pedro Francisco appeared in standard-issued grey prison garb as she described her deteriorating condition.
When she tries to walk, she said, she struggles because the pain from her stomach shoots into her legs and back. It hurts when she urinates.
About a month after her emergency room visit, Pedro Francisco requested from ICE a bottom bunk bed due to her pain. According to her medical records, ICE officials denied the request.
Instead of ICE providing Pedro Francisco with surgery, available documentation appears to show that the agency may be treating her “for a condition she doesn’t have,” according to Dr. William Weber, who practices emergency medicine in Minnesota and leads a nonprofit focused on care in detention facilities.
Weber and four other experts who reviewed Pedro Francisco’s records said that they suggest that ICE medical staff may have incorrectly diagnosed her with Polyendocrine Metabolic Ovarian Syndrome, a common condition for women of reproductive age, that can lead to cysts that are not typically painful or dangerous.
Except her previous medical records don’t support that, Weber and other experts said. He added that it appeared that a male nurse practitioner in ICE provided that assessment without giving Pedro Francisco an ultrasound or the extensive examination a diagnosis for that condition requires.
“Either the nurse practitioner just doesn’t know the difference, because they have much less training than a physician, so maybe they just didn’t know,” Weber said. “Based on her records, ICE never documented any rationale for diagnosing her with that, nor did they do any testing.”
Part of the treatment for PMOS was over-the-counter pain relievers, which Pedro Francisco said did nothing for her discomfort.
Dr. Lauren Thaxton, a Colorado gynecologist, said the treatment she is receiving in detention is “inconsistent” with what her gynecologist recommended. Thaxton added that her condition “should be surgically explored.” That Pedro Francisco’s pain has persisted over months necessitates an operation, Thaxton said.
Seven doctors reviewing Pedro Francisco’s medical records warned her ovaries are at risk of damage, which could affect her ability to have a baby.
Not operating soon means that Pedro Francisco’s ovary could become “nonfunctional within her body due to the lack of blood supply,” said Thaxton, echoing other experts. “This is not a reversible outcome.”
Dr. Kristyn Brandi, a New Jersey gynecologist, worries that her cyst could be cancerous.
“Removing it early would be important to stop the spread of disease,” Brandi said.
“It is inhumane for a patient having so much pain that she was scheduled for surgery to be held without treatment,” she added.
Monnig, the Louisiana doctor, wrote in Pedro Francisco’s humanitarian parole petition that if her cyst continues to remain untreated, it could rupture, killing one of her ovaries and causing complications such as sepsis and infertility, requiring greater surgical interventions that could result in “larger incisions, and pain, brain damage or death.”
Pedro Francisco said that it’s distressing to hear from attorneys and experts that the lack of medical care could imperil her ability to have children, whom she desperately wants.
“I love children, they are beautiful,” she said. “But I guess right now I first need to see what is going to happen to me.”
Ruby L. Powers, another of Pedro Francisco’s attorneys, said Pedro Francisco is being “gaslit” by ICE medical staff.
“What the ICE medical team is telling her simply doesn’t match up with what doctors in the outside world say,” Powers said. “This is barbaric treatment at best and deadly at worst.”
“Getting worse every day”
Pedro Francisco was born in the Guatemalan Western Highlands, the site of the Central American country’s worst civil war massacres. She and her mother said in interviews that as indigenous people, they suffered discrimination and poverty. Her mother was sexually assaulted. And Pedro Francisco’s relative was killed in what the family believes was a targeted gang-related attack. That spurred the mother to bring her then 16-year-old daughter to the U.S. in 2019, where they requested asylum at the border.
Trump’s first administration released them while their asylum cases proceeded in the backlogged civil immigration courts. They continued to Minnesota, where they had family and joined an evangelical church, found jobs, and set down roots. Pedro Francisco’s mother had two U.S. citizen children.
Pedro Francisco worked cleaning jobs with her mother and doted on her siblings. She played bass and sang for her church’s musical group.
Zoila Carrion Caceres, who knew Pedro Francisco from high school and played music with her in the church group, said she has “a way of making people laugh and feel comfortable.”
Carrion Caceres wrote in a declaration for Pedro Francisco’s humanitarian parole that she “not only brought leadership but also joy and a sense of unity.”
Another of Pedro Francisco’s friends, Laura Carrion, said that she served as a leader for the deacons, helping new members “in understanding the Bible.” To obtain that position, Carrion said, Pedro Francisco underwent “strict interviews and character evaluations with our Pastor.”
Pedro Francisco had been suffering severe stomach pain for years, she and her family said, that escalated in recent months and prevented her from working. She said that she didn’t want to seek medical care because she worried about the cost. So her family and friends were relieved when she was scheduled for surgery, urged by Fairview Hospital staff in Minnesota, according to her records.
Then, this February, Pedro Francisco was driving with her mother and siblings when federal agents stopped them as part of Operation Metro Surge in Minnesota, an unprecedented immigration operation in that state that resulted in two U.S. citizen deaths and helped lead to the ouster of at least two top Homeland Security officials.
Neither Pedro Francisco nor her mother had a deportation order, according to her lawyers, since they had been released into the U.S. under Trump’s first administration. Later, the Biden administration dismissed their immigration cases in a judicial move known as prosecutorial discretion.
But the agents detained Pedro Francisco, allowing her mother, who holds the same immigration status, to leave with the U.S. citizen children, presumably because the kids, aged 1 and 5, have no other caretakers, attorneys said.
Along with about 3,400 immigrants from Minnesota, ICE flew Pedro Francisco to Texas and imprisoned her at El Paso’s Camp East Montana, a troubled detention facility where at least three immigrants died in the weeks before she landed.
Pedro Francisco’s lawyer, Syed, filed a legal claim known as a habeas petition for her in February. Data shows that such filings, which argue that people are wrongfully detained, have surged under Trump’s second administration. The largest number of filings are coming from the Western District of Texas which has jurisdiction over Camp East Montana and the South Texas Family Residential Center, known as Dilley, that is the only facility in the U.S. to currently hold parents with their children.
Syed’s petition landed in front of U.S. District Court Judge Leon Schydlower, a Biden appointee. But as with many of such appeals before him, Schydlower waited months to issue a ruling and when he finally did, the denial appeared to be a “copy and paste,” according to more than half a dozen other Texas lawyers who voiced the same complaint for similar petitions that have appeared before him. Schydlower did not respond to requests for comment.
“Andrea’s case is why habeas was made,” said Powers, her attorney.
“Andrea’s case is why habeas corpus exists,” said Powers, her attorney. “ICE arrested her five days before that surgery. The Constitution doesn’t have an asterisk for immigrants. When the government takes someone’s freedom, it takes responsibility for their life. Right now, it’s failing.”
Syed filed a temporary restraining order. Schydlower denied that, too.
Camp East Montana has been under blistering criticism, not only for the three deaths there over a span of six weeks but internal inspection reports citing dozens of violations. In March, the administration suddenly changed contractors. Pedro Francisco was abruptly moved to the El Paso Processing Center, a separate ICE facility. But the transfer did nothing to ease her pain.
“I feel like I’m getting worse every day,” Pedro Francisco said in an interview last week. “At night I don’t sleep well and in the day I don’t feel like the same person.”
For now, she holds out hope, although it is waning.
So does her mother, who said that the family relies on Pedro Francisco, financially and emotionally. Her daughter has no one in Guatemala and her removal, the mother said, would leave her American siblings “ruined.”