Medical emergencies see sharp rise at Miramar ICE facility in midst of overcrowding

When Alexander Iván Aguilar Borjas called his wife from inside the U.S. Immigration and Customs Enforcement field office in Miramar, he told her he needed his daily HIV medication, but he could not get at it, even though it was nearby.

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The medication was inside the backpack ICE officials had taken from him when they detained him days earlier.

Aguilar Borjas told his wife, Rebeca Aguilar, that he had not been allowed to take it. He had been held for days in a crowded room, she said, and his calls home generally lasted only two or three minutes.

Aguilar kept her cellphone line open, worried she would miss the next call.

“He has to take the medication every day,” she said.

Aguilar Borjas’ calls came in mid-July, as families and immigration attorneys said the Miramar field office — historically an administrative location where immigrants report for scheduled ICE check-ins —was increasingly being used to hold people for days at a time. Records requested by the Miami Herald show that 911 medical calls to the southwest Broward facility’s address rose sharply during the 12-month period ending July 1.

Going without medication

Families say relatives held at the facility have become ill, go without regular medications and are forced to sleep on the floor while awaiting release or transfer to formal detention centers like Krome North Processing Center in southwest Miami-Dade County.

City records show firefighters and emergency medical personnel have been repeatedly dispatched to the facility for chest pain, breathing problems, seizures, fainting and other medical complaints. Miramar Fire Rescue, for example, logged 49 calls to the facility in June.

The Miramar site has historically operated as an administrative check-in office, not a long-term detention facility. As ICE has begun holding people there for days, the office has effectively taken on some of the functions of a detention center, with unanswered questions about whether it has the medical staff, equipment and living conditions needed for that use. The rising number of emergency responses is one of the few public indicators of what may be happening inside rooms that reporters and relatives cannot access.

The issue has become especially concerning for immigrant advocates who worry that with the end of Temporary Protected Status for more than 350,000 Haitians, many of whom live in the South Florida, more and more people will be detained at the ICE check-in site in the coming weeks and months.

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The records obtained by the Herald do not reveal who received care or establish whether conditions inside the facility caused the emergencies. Also, unclear from the information is whether the patients were detainees, ICE employees, contractors or visitors.

ICE did not respond to questions about the individual cases, medical staffing at the office or the number of people currently being held there. When advocates recently held a news conference outside the facility to denounce a surge in immigration arrests across South Florida, the Herald learned of immigrants being processed in a garage at the office. Advocates said the increased number of immigration arrests is straining detention capacity in the region.

Endangered health

Aguilar said her husband, a 53-year-old construction worker from Honduras, was detained on July 10 while working in Plantation and taken to the Miramar office.

During their calls, he described being held with about 150 people. He told her he had not been permitted to shower and was not receiving his antiretroviral medication.

Aguilar said treatment had suppressed the amount of the HIV virus in her husband’s blood to undetectable levels. She feared that an extended interruption could allow the virus to rebound and endanger his health.

She traveled from the family’s Little Havana home to Miramar to tell officials that her husband needed the medication. Aguilar said personnel did not tell her whether he would be evaluated or given it.

“They were very unpleasant,” she said. “It was like we didn’t exist.”

During one of their early conversations, she said, her husband sounded as though he had been crying.

Aguilar said officials were pressuring him to sign paperwork agreeing to leave the country voluntarily. She told him not to sign anything without first receiving legal advice.

The family struggled to hire an attorney. Aguilar said her husband was the household’s primary source of income and helped care for their three children, all of whom have autism. She said her own medical conditions prevent her from working.

“I don’t know what else to do,” she said.

Medical emergencies

Earlier Miramar fire rescue city records show the scale of emergency responses at the address before Aguilar Borjas arrived.

Miramar Fire Rescue logged 194 incidents at the facility, located at 2805 SW 145th Ave., from July 1, 2025, through July 1, 2026, according to a Miami Herald analysis.

The calls accelerated near the end of the period. Fire Rescue recorded 25 incidents in May, followed by 49 in June — the highest complete monthly total in the data. Eight more were logged on July 1 alone.

Those 82 incidents between May 1 and July 1 represented about 42% of the yearlong total of calls from the facility.

On July 1, rescue crews were sent to the address for a sick person shortly after 9 a.m. Another incident involving someone who was unconscious or had fainted was logged nine minutes later.

Before the day ended, Fire Rescue recorded calls for a diabetic emergency, abdominal pain, breathing problems, a headache and two seizures.

The most common dispatch descriptions over the year were sick persons, non-traumatic chest pain, trouble breathing, unconsciousness or fainting, abdominal pain and diabetic emergencies. The records also included strokes, seizures, bleeding, injuries, allergic reactions and heart problems.

The report does not contain patient names, confirmed diagnoses or detailed treatment narratives. It also does not show whether each person was treated at the scene or transported to a hospital.

‘I couldn’t imagine’

Paul Chavez, an attorney with Americans for Immigrant Justice, said medical emergencies occur throughout the immigration detention system. But he said the volume documented at Miramar stood out.

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“I couldn’t imagine any place calling 49 times,” Chavez said of the June total.

“If it was a medical facility, then they would just treat it inside,” he said. “They wouldn’t have to call 911.”

Chavez said the rise appears to coincide with a shift in how the Miramar office is being used.

Historically, he said, people visited the office for immigration check-ins and either left or were transferred relatively quickly after an arrest. Over roughly the past three to six months, his organization has increasingly heard reports of people remaining there for several days.

The building was not designed or equipped to house people for those lengths of time, Chavez said. People with chronic illnesses may arrive with medication that is taken from them as personal property, while relatives who try to deliver medicine are turned away, he said.

Families have told his organization that officials said medication must be prescribed internally, Chavez said. If no medical provider is available to issue that prescription, the detainee may be unable to receive medicine already present in the building.

“If somebody has diabetes, for example, and they go to a check-in, and they’re arrested for detention, and they end up staying at Miramar for a long period, they’re not getting their medication,” Chavez said.

Chavez said missed medications, combined with crowded rooms, limited hygiene, insufficient sleep, heat and possible dehydration can contribute to medical emergencies.

Chavez said his organization and other civil-rights groups are investigating conditions at the facility. Someone held for an extended period may seek relief from federal courts, he said, but limited access to attorneys and short, interrupted calls can make it difficult for relatives to act quickly.

María Alejandra Betancur’s father, Carlos, was detained July 8 while filling up at a gas station near the family’s Doral home, she said.

Carlos Betancur has a work permit, a Social Security number, a pending asylum application and no criminal record, his daughter said. By July 14, he had spent six days inside the Miramar office.

He told his family that he had developed a fever, severe throat pain and respiratory symptoms, Betancur said. He requested medication but received only salt water to soothe his throat.

Carlos Betancur has a hip replacement and five herniated spinal discs. He told relatives detainees were sleeping on the floor or standing for long periods because there was not enough space for everyone to lie down, worsening his pain.

He described about 90 people sharing a confined room with one clogged portable toilet, his daughter said. Detainees could not shower and had begun organizing among themselves to clean the space, according to her father’s account.

Carlos Betancur also told his family that he witnessed another man suffer from convulsions and bleed from his mouth.

Other detainees initially tried to assist the man while calling for officers, according to Betancur’s account of what her father told her. It remains unclear how long it took medical personnel to respond or whether the man was transported to a hospital.

Betancur said calls were sometimes interrupted when her father discussed conditions inside. During one call, she said, people in the background repeatedly told him to hang up as he described the reported seizure. Another call disconnected after the family told him they had obtained an attorney.

The accounts could not be independently verified and records provided to the Herald end before Carlos Betancur and Aguilar Borjas were detained.

ICE’s revised 2025 National Detention Standards describe hold rooms as temporary spaces for people awaiting removal, transfer, medical treatment, court proceedings or other processing.

The standards say a person may not be held in a hold room for more than 12 hours. Multiple-occupant rooms must provide minimum space for each additional detainee and contain enough seating for their maximum posted capacity. The standards also list other requirements including that staff must immediately contact emergency medical services when a detainee appears to need emergency treatment.

ICE issued a nationwide waiver in June 2025 that allowed field offices to hold people for up to 72 hours, citing limited transfer options and the inability to release some detainees.

The change prompted lawsuits involving ICE holding rooms in Baltimore, New York and San Francisco. Plaintiffs said they were held in overcrowded rooms without adequate medical care, hygiene supplies, bedding, food, water or access to attorneys.

Courts in some of those cases imposed minimum requirements involving medical screening, sanitation, sleeping conditions and confidential legal calls.

It remains unclear which detention standards ICE considers applicable to the Miramar office, whether detainees receive medical screenings there and what policy has governed holding periods since the waiver was vacated.

For Aguilar, those policy questions remain tied to the next call from her husband.

She does not know when he will be moved, whether he received the medication stored inside the building or how long she will be able to hear his voice when the phone rings again.

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Until then, she keeps the line available.