A 36-year-old Costa Rican man with Type 1 diabetes repeatedly complained that he was missing insulin, meals and adequate water while in US immigration detention before being found unresponsive at a Louisiana facility and later dying at a hospital, according to his family and a fellow detainee.
Carlos Josué Marchena Marchena was found unresponsive on 18 September at Winn Correctional Center in Winnfield, where staff began resuscitation efforts, US Immigration and Customs Enforcement said.
He was taken to Winn Parish Medical Center, where doctors continued trying to revive him before pronouncing him dead at around 8am. His official cause of death remains under investigation.
Family Says His Health Deteriorated in Detention
Marchena's sister, girlfriend and a detainee housed beside him told the Associated Press that he had complained about inconsistent insulin injections, missed meals, and not receiving enough water while being transferred between immigration detention facilities. His sister, Franciny Marchena, said he told her his blood sugar was not being checked regularly.
After arriving at Winn less than a week before his death, his condition appeared to worsen, his family said. He reportedly complained of chest pain and said some of the food he received was spoiled.
Luis Herrera Andy, a Honduran detainee held in the neighbouring cell, told the AP that Marchena appeared pale and sweaty the day before his death and suffered vomiting, headaches, chills and stomach pain.
Marchena's girlfriend, Ana Leon Castro, said he telephoned her around midnight before his death and told her that medication he had been given for his chest pain was not helping.
ICE disputes suggestions that he received inadequate treatment. 'Marchena received proper medical care and was seen by medical professionals,' the agency said.
Diabetes Requires Regular Insulin and Food
Dr Rajesh Garg, head of the diabetes unit at Harbor-UCLA Medical Center, told the AP that people with Type 1 diabetes require regular insulin, food, water and blood-sugar monitoring.
He said vomiting, nausea, headaches and abdominal pain can be signs of a dangerous insulin deficiency, although those symptoms can also have other causes. The medical evidence has not yet established whether diabetes directly caused Marchena's death.
Medical examiners have, however, identified diabetes as a contributing factor in at least six ICE detainee deaths since Donald Trump returned to office in January 2025, according to the AP.
Marchena is at least the 58th ICE detainee to die during that period, according to the news agency's tracking.
Winn Had Not Fully Met Medical-Care Standards
Marchena's death has renewed scrutiny of conditions at Winn, where two other ICE detainees have died since April.
A Department of Homeland Security Office of Inspector General report published in June found that the facility did not fully comply with federal standards covering medical care, food service, environmental health and safety, use of force and several other areas.
Inspectors found, among other problems, that medical staff failed to maintain updated treatment documents and laboratory testing records, shortcomings they warned could negatively affect detainee health care and safety. ICE agreed with nine recommendations for improvements.
LaSalle Corrections, which manages the facility with the Winn Parish Sheriff's Office, said Marchena's death was under review and that it remained committed to 'the highest standards of care'.
Marchena, who worked as a ride-service driver and had four children, was ordered deported to Costa Rica in July. His sister said he had requested bail and voluntary deportation to Costa Rica, but the request was denied. His family is now waiting for medical examiners to determine what caused his death and whether the care he received in custody played any role.
