Evidence shows that government doctors "purposefully mischaracterized (Castaneda's) medical conditions as elective in order to refuse him care" and save money.


The family of an Undocumented immigrant who died of penile cancer that went untreated during 11 months of detention can sue government doctors for damages, a federal judge has ruled in a decision in which he condemned the defendants' alleged actions as deceptive and heartless.

The claims in Francisco Castaneda's lawsuit - that government medical staffers and immigration officials brushed off his complaints of severe pain and multiple lesions, told him they saw no need for surgery and finally discharged him rather than having the government pay for treatment - describe conduct that, if proved, "is beyond cruel and unusual," said U.S. District Judge Dean Pregerson of Los Angeles.

His ruling, issued late Tuesday, allows Castaneda's family to sue the doctors for allegedly violating his constitutional rights and ask a jury to award punitive damages. Government lawyers argued that federal law allowed only a suit against the government, with a nonjury trial and a $250,000 limit on damages.

Castaneda, 36, died Feb. 16 at his Los Angeles-area home, a year after doctors amputated his penis to try to stop the spread of the cancer. He had entered the United States with his mother at age 10 after fleeing his native El Salvador during a civil war. His family will take over the lawsuit.

Attorney Conal Doyle of Oakland, who sued state and federal doctors and officials on Castaneda's behalf in October, called Pregerson's ruling "a tremendous and unprecedented victory" in a tragic case.
"Every American should be ashamed by the conduct of the government in this case," Doyle said.

Thom Mrozek, spokesman for the U.S. attorney's office in Los Angeles, said the government was reviewing its options, including an appeal.

Castaneda was convicted in 2005 of possessing methamphetamine and spent eight months in jail, then was held in immigration detention centers in San Diego and San Pedro while awaiting proceedings on deportation and his claim for political asylum.

According to his lawsuit, a doctor first noticed a growth on Castaneda's penis in December 2005, while he was in state custody, and ordered further tests that were never conducted.

Multiple lesions developed and his pain increased while he was in prison, but doctors and U.S. Immigration and Customs Enforcement agency officials turned down medical staff recommendations for a biopsy and surgery, the suit said.

Quoting government records, Castaneda's lawyers said the federal agency and its doctors knew Castaneda had a family history of cancer - his mother died of the disease at age 39 - but rejected a cancer specialist's recommendation for a biopsy, describing it as an elective procedure.

Castaneda "needs to be patient and wait," the agency's health service wrote in June 2006 as his condition worsened. Five months later, in response to observations of discharges from his lesions, the health service recommended that he receive a clean pair of boxer shorts each day.

A doctor finally ordered a biopsy in late January 2007 and said Castaneda probably had cancer, but Immigration and Customs Enforcement released him 11 days later rather than having him treated, the suit said. He underwent the biopsy and amputation at a county hospital.

Castaneda testified in October to a congressional committee looking into medical care at immigration detention centers. Rep. Zoe Lofgren, D-San Jose, who presided over the hearing, criticized Immigration and Customs Enforcement afterward and said that "civilized people don't let the persons who are in their custody die for preventable reasons."
Virginia Kice, a spokeswoman for the agency, said in response that Immigration and Customs Enforcement took the health needs of its 300,000 detainees seriously, screened all new detainees for health problems and referred them to specialists when necessary.

In Tuesday's ruling, Pregerson said Castaneda's claims, if true, would show not merely medical malpractice - covered by the federal law that allows suits for limited damages - but intentional violations of his constitutional rights, for which juries can award higher amounts.
"The evidence that plaintiff has presented so far - through (government officials') own records - suggests a strong case for punitive damages because it shows that (their) behavior was callous and misleading," the judge said.

He said there was compelling evidence that government doctors "purposefully mischaracterized (Castaneda's) medical conditions as elective in order to refuse him care" and save money.