Arizona ICE detainee's death related to severe dental problems, medical examiner says

Emmanuel Damas, 56, died March 2 at a Scottsdale hospital after complaining of intense tooth pain and later a swollen neck while detained at Florence, which is owned and operated by CoreCivic, a for-profit prison company. After a week of pleading for help, Damas was only taken to the hospital after he collapsed at Florence, his family said.

Damas' family was with him when he was removed from life support, 11 days later.

The Maricopa County Medical Examiner's website posted a brief update on Damas' case this week, describing his primary cause of death as: "Complications of necrotizing mediastinitis with neck and retropharyngeal abscess in the setting of severe dental caries (cavities) and periodontal disease."

"Necrotizing mediastinitis" is a life-threatening infection of the chest that often originates in the mouth or throat. A "retropharyngeal abscess" is a build-up of pus in the back of the throat.

Dentist John Osborn said the listed cause of death indicates that Damas had severe cavities and gum disease that allowed bacteria to travel from his mouth into the soft tissues of his throat and chest, and into his bloodstream, which would cause sepsis.

Osborn, who was not involved in Damas' care, is a dentist and volunteer director of Remote Area Medical, or RAM, which provides free dental care in low-income communities.

As bacteria spread through Damas' body, "it sounds like that created the opportunity for a blood-borne infection and that's what killed him," Osborn said. "It sounds like his infected teeth killed him."

The medical examiner's office has not yet released its full report on Damas, one of 18 detainees in U.S. Immigration and Customs Enforcement custody who have died so far in 2026.

Doctors told Damas' family in March that he died from septic shock, likely due to bacteria from a tooth infection that spread to his throat and lungs. 

Damas' family has called for an investigation into what his brother Presly Nelson called his "totally unnecessary" death. Nelson, who has lived in the U.S. for nearly 30 years, sponsored his brother to come to the U.S. through a Biden-era parole program in 2024.

"I need to know what happened here," Nelson told the Star in March. "If there is negligence, then whoever dropped the ball needs to be accountable for it. If this is how the policy is set up, then those protocols need to be reviewed. Because in the last few months, we have too many of those deaths" in ICE custody.

ICE's National Detention Standards say, "Emergency dental treatment shall be provided for immediate relief of pain, trauma, and acute oral infection." Advocates say those standards are written by ICE and are not legally binding.

Osborn said dental infections can become life-threatening, but tooth problems are often ignored, usually for financial reasons. Dental care isn't covered under regular health insurance, and medical doctors' training doesn't teach much about teeth, he said.

"That gives people the mistaken idea that dental infections are not that serious, but they can definitely be life-threatening," he said.

ICE deaths soaring

CoreCivic's Brian Todd declined to answer the Star's questions about Damas' care, including whether any reforms had been put in place to prevent future deaths.

In an emailed statement, Todd said CoreCivic "will continue to ensure that all detainees receive appropriate and timely medical attention."

At ICE facilities where CoreCivic oversees medical care, like Florence, "all detainees have daily access to sign up for medical care, including mental health service," as well as access to off-site care and on-site health professionals, Todd said.

Damas' family said he was just given ibuprofen for his pain at Florence.

"While we're unable to share specific information about a detainee's medical care due to federal privacy laws," Todd said, "we are committed to providing safe, humane and respectful care for everyone entrusted to us."

Deaths in ICE custody have risen significantly under the second Trump administration, as Trump officials have worked to increase the number of immigrants detained and held in civil detention, mostly by arresting immigrants without any criminal records, ICE data show.

Nearly 90% of ICE detainees are held in facilities run by private prison companies, like CoreCivic and Geo Group, which have seen their profits surge since Trump took office.

On Tuesday, Trump announced former Geo Group executive David Venturella as the new acting director of ICE, the New York Times reported. 

ICE reported 32 detainee deaths in 2025, nearly triple the number of deaths in 2024.

Several U.S. lawmakers have also called for an investigation into Damas' death, including Arizona Democratic Reps. Adelita Grijalva, Greg Stanton and Yassamin Ansari; and Massachusetts Democrats Sen. Edward J. Markey, Sen. Elizabeth Warren and Rep. Ayanna Pressley.

"The medical examiner’s preliminary findings make this preventable tragedy even more horrifying," Grijalva said in a statement Wednesday on the medical examiner's update. "A toothache should never escalate into a fatal medical emergency, especially while someone is in government custody and entirely dependent on detention staff for access to care. This raises serious and still unanswered questions about why Emmanuel Damas did not receive timely medical attention and why repeated requests for care were ignored."

Grijalva called for accountability and "robust congressional oversight" of ICE facilities, where "we continue to see a deeply disturbing pattern of medical neglect, delayed treatment, and systemic cruelty."

DHS has tried to force legislators to give seven days' notice before inspecting ICE facilities, despite federal law allowing for unannounced inspections by members of Congress and their staff.

"When the federal government detains someone, it assumes responsibility for their safety, health, and well-being," Grijalva said in the statement. "This is exactly why robust congressional oversight is necessary. Mr. Damas deserved to be treated with dignity. Instead, he died in federal custody from a preventable condition that could have been easily treated with timely medical care. DHS must immediately provide full transparency and accountability for what took place and explain what steps are being taken to ensure that this never happens again."