NEW ORLEANS (AP) — A 36-year-old Costa Rican man whose family says he complained of missing insulin shots and meals to manage his diabetes is the third detainee to die in less than six months at a U.S. Immigration and Customs Enforcement facility in Louisiana.
Carlos Josue Marchena Marchena was found unresponsive Sept. 18 at Winn Correctional Center in Winnfield, ICE said in a statement. It said staff began lifesaving measures before he was taken by
ambulance to a hospital where he was later pronounced dead.
The man's sister, his girlfriend and a detainee held in the cell beside Marchena's told The Associated Press that he complained of missed meals and shots and not drinking enough water to control his type 1 diabetes as he was moved between facilities in multiple states. Marchena's condition worsened after he arrived at Winn, and he died less than a week later, his family said.
The official cause of death is pending further medical examination.
The correctional center had recently been found to have fallen short of federal standards, including for medical care, by the Department of Homeland Security’s Office of Inspector General.
Two other ICE detainees have died at the complex since April.
Marchena is at least the 58th ICE detainee to die since President Donald Trump returned to office in January 2025, according to tracking by AP. Immigrant advocates say the deaths are a sign that authorities are failing to properly oversee the detention of tens of thousands of immigrants swept up in the administration’s aggressive deportation strategy.
ICE said Marchena's medical care was appropriate. “Marchena received proper medical care and was seen by medical professionals,” an agency statement said.
Sufficient food, water and insulin at regular intervals is crucial with type 1 diabetes for managing blood sugar levels to avoid a life-threatening health condition, said Dr. Rajesh Garg, who heads the diabetes unit at the Harbor-UCLA Medical Center.
“If they are under any stress, then they need even more care and then they need to test their blood sugar at regular times,” Garg said. “If there isn’t proper food and water, that is going to stress his system.”
Scott Sutterfield, a spokesperson for LaSalle Corrections, the contractor managing the facility with the Winn Parish Sheriff’s Office, said the death is under review and declined to answer questions. He said the company is committed to “the highest standards of care.”
Winn Parish Sheriff’s Office and the Winn Parish Coroner’s Office did not respond to requests for comment.
Medical examiners and coroners have ruled diabetes was a contributing factor in at least six of the ICE detainees' deaths during Trump’s second presidency. Detainees with diabetes have frequently complained in court filings of inconsistent access to insulin and other medications.
The deaths come amid mounting scrutiny of ICE detention facilities and whether they are medically neglecting detainees and forcing them to live in inhumane conditions, charges that ICE denies.
Homeland Security’s Office of Inspector General issued a report in June that said an unannounced inspection at Winn found violations of standards governing medical care, food service, use of force and other subjects. Among violations, it reported frozen food not being stored properly.
Medical staff at Winn failed to keep updated treatment documents and laboratory testing records, which could “negatively impact detainee health care and safety,” the report warned. It said ICE agreed with nine recommendations to improve conditions at Winn, and had implemented several of them.
Marchena's sister, Franciny Marchena, said her brother told her no one was checking his blood sugar levels to ensure they were stable.
“A person who is healthy and taking their diabetes medication has no reason to collapse the way my brother did,” she told AP, speaking in Spanish from Costa Rica.
His sister said his health began to worsen about two weeks ago when he was in an immigration detention center in Michigan and was put in a security cell after an argument with another detainee.
After being transferred to Winn, Marchena told his sister and girlfriend that he had chest pain and was not getting enough to drink or eat, including because the food was sometimes spoiled. It was not known if he had an underlying heart condition.
Marchena also voiced these concerns to Luis Herrera Andy, a Honduran man detained at Winn in the adjacent cell, who noted Marchena only received irregular insulin shots.
A doctor gave Marchena pills for his chest pain but he returned angry, Herrera said, recalling his words: “This place is crap. They don’t help you with anything here. You could even die here."
The day before Marchena was found dead, he had stomach pain, headaches, chills, and was vomiting, Herrera said. He was a pale purple color and wet with sweat.
Hours before his death, Marchena's girlfriend Ana Leon Castro said, he called around midnight to say the pills weren't helping.
“All they gave him was a pill — that was it for the treatment,” Leon Castro said.
Cardiac arrest — when the heart suddenly stops pumping — can occur from too little or too much insulin in a diabetic person, said Garg at Harbor-UCLA. Vomiting, headaches, nausea and stomach pain are all symptoms that can indicate a life-threatening insulin deficiency, though there could be other causes such as an infection.
Marchena was the first Costa Rican detainee to die in an ICE facility under Trump’s second presidency.
He entered the U.S. without legal status in February 2021, ICE said in a statement.
ICE said Marchena had prior misdemeanor convictions for retail fraud and property destruction before he was arrested in January by the Ottawa County Sheriff's Department in Michigan for assault. In July, an immigration judge ordered him to be deported, according to DHS.
His sister Franciny said Marchena, who worked as a ride service driver and had four children, had requested bail and voluntary deportation to Costa Rica, but it was denied. ICE did not respond when asked about the denial.
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Pineda reported from Los Angeles. Associated Press reporter Ryan Foley contributed from Iowa.
