This week, the family of an undocumented Guatemalan immigrant who sustained serious injuries in an accident was able to stop his deportation from a Pennsylvania hospital⁠—a deportation organized not by federal immigration authorities, but by the hospital itself.

On May 10, A.V. (initials of the patient used to protect his privacy) was seriously injured in Philadelphia when a man on a motorcycle crashed into him. The undocumented immigrant, who is in his late 40s, was taken to Jefferson Torresdale Hospital with two broken legs, fractured ribs, and trauma to his head. In the weeks that followed, the hospital decided it would no longer provide care to the undocumented and uninsured A.V. and—without his consent or the consent of his family—instead attempted to arrange for his “medical repatriation,” or deportation, to Guatemala. After a public outcry, the hospital was forced to stop the deportation.  

The ordeal started when the day after the accident, A.V.’s niece, Claudia Martinez, said she received a call from the hospital to “identify” her uncle.

“They wanted to make sure it was him. They weren’t sure because of the severe nature of the accident,” Martinez said with the help of an interpreter. “I just knew at that moment that the accident was going to change his life. He suffered a lot and I knew it would take him a long time to recover.”

But it seems Jefferson Torresdale Hospital was only willing to give A.V. a few weeks of care before arranging with the Allentown, Pennsylvania, company MedEscort International for a “medical repatriation,” the deportation of an undocumented patient in need of chronic care to their country of origin. Patients often do not give their consent to be medically deported. Rather, the decision is made by insurance companies, doctors, hospital financial offices, and administrators. Medical deportations have taken place for years.

While hospitals in the United States have a legal mandate to provide emergency care regardless of the patient’s immigration status, federal Medicare programs only reimburse hospitals for minimal emergency care treatment, according to the law firm Norris McLaughlin. This means that long-term care, rehabilitation, and extended hospital stays⁠—all care that A.V. requires—are not covered. For that reason, it appears Jefferson Torresdale Hospital decided to deport him.

A spokesperson for Jefferson Torresdale Hospital did not respond to Prism’s questions about how common a practice this is at the hospital, or whether they have deported undocumented patients in the past.

David Bennion, an immigration attorney and the founder of the Free Migration Project, a grassroots organization that advocates for open borders, has been helping the family to stop A.V.’s deportation. He said watching the situation unfold has been “aggravating.”

“[The hospital] would rather pay for insured care this long and then charter a private flight than pay some nominal amount to have an immigration consultation or work with community partners that serve the immigrant community,” Bennion said.

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Martinez told Prism she feared something was afoot when about two weeks after her uncle’s accident, she received a call from a social worker at the hospital who had a “serious conversation” with her in English about A.V.’s care. Martinez speaks Spanish.

“What I understood [from the call] was that she was asking me if my uncle was undocumented; if he was ‘legal’ in this country. I told her the truth; I told her my uncle did not have papers,” Martinez said.

Fast forward to earlier this month when Martinez received a call from MedEscort informing her that they were making arrangements to send her uncle to Guatemala. Martinez said she was told that her uncle could no longer receive care at Jefferson Torresdale Hospital because of his immigration status and because he didn’t have medical insurance.

“‘It is better for him to go back to his country,’ that’s what they said to me,” Martinez said.

A.V. has not lived in Guatemala for years and according to information shared with Prism, the hospital in Guatemala where Jefferson Torresdale and MedEscort arranged to send him was over capacity because of COVID-19, and lacked even basic rehabilitation services. It is also unclear how MedEscort would have carried out the deportation given that Guatemala’s airports are closed due to the coronavirus pandemic.

A spokesperson for Jefferson Torresdale Hospital would not share specifics of A.V.’s case but said: “We do not, nor would we ever, make an independent decision related to a patient’s care or their placement. While those decisions are informed by the patient’s clinical needs, final decisions are made by the patient, or if the patient cannot make such decisions, their family or legal representative.”

Martinez alleges that the hospital was “absolutely” going to deport her uncle to Guatemala without a care plan or concern for his long-term care, and she said that no one in their family in Philadelphia ever consented to her uncle’s medical deportation. Neither did A.V., his wife in Guatemala, or their adult children.

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A.V.’s family decided to fight the deportation. Medical students from the hospital circulated a petition to stop his removal. Advocates protested outside of the hospital the morning of June 24, the day A.V. was set to be deported. Martinez’s family found support and allies in the Free Migration Project and the Shutdown Berks Coalition, which fights to shut down the Berks Family Residential Center, a family detention center in Leesport, Pennsylvania.

Together, they were able to stop A.V.’s deportation—at least temporarily. Jefferson Torresdale Hospital has given the family four weeks to figure out a care plan of their own. Martinez said the family is struggling to decide what to do next. The entire ordeal has left her “shocked.”

In screenshots of emails and phone records shared with Prism, it’s clear that a MedEscort employee named Craig was in regular contact with A.V.’s family and on the day of A.V.’s scheduled deportation, he called the family repeatedly. According to the Shut Down Berks Coalition, Craig threatened to call ICE on A.V. In another instance, A.V.’s family said Craig told them that if they blocked the deportation, he would personally drop A.V. off at their home.

When Prism reached out to Craig, he said he had “no knowledge of the situation” and threatened to call his attorney on both Prism and A.V.’s family, alleging both violated his “privacy and rights” by sharing his “private number.” However, the number Craig was reached on appears repeatedly in work emails Craig sent to the family in his capacity as a MedEscort employee.

Martinez said that before this ordeal, she had no idea that hospitals could make these types of unilateral decisions.

“I didn’t know hospitals had the power to do this. I’m shocked. There was so much I did not understand about this process,” Martinez said. “What I can say is that the hospital made these decisions without our consent and without an interpreter so that we can understand these matters. They cannot just deport patients like this.”