A 36-year-old man from Costa Rica, Carlos Josue Marchena, was found unresponsive on September 18 at Winn Correctional Center in Winnfield, Louisiana, and later died at a hospital. According to U.S. Immigration and Customs Enforcement (ICE), staff began lifesaving efforts before he was transported to the hospital. His family, including his sister, girlfriend, and a detainee from a neighboring cell, told The Associated Press that Marchena had reported missing meals, missed insulin doses, and insufficient water to manage his type 1 diabetes, especially as he was moved between facilities across multiple states. His condition reportedly worsened after arriving at Winn, and he died less than a week later. The official cause of death is still under investigation. Marchena is the third detainee to die at Winn Correctional Center in less than six months. Previously, the Department of Homeland Security’s Office of Inspector General found that the facility had not met federal standards, including for medical care. Two other ICE detainees have died at the facility since April, and nearly 60 ICE detainees have died since January 2025. According to The Associated Press, Marchena is at least the 58th ICE detainee to die since President Donald Trump returned to office in January 2025. Immigrant advocates argue that these deaths highlight a lack of proper oversight in the detention of thousands of immigrants. ICE stated that Marchena received appropriate medical care and was seen by medical professionals. Dr. Rajesh Garg, who leads the diabetes unit at the Harbor-UCLA Medical Center, emphasized that managing type 1 diabetes requires consistent access to food, water, and insulin at regular intervals to prevent life-threatening complications. Scott Sutterfield, a spokesperson for LaSalle Corrections, the company managing the facility with the Winn Parish Sheriff’s Office, said the death is under review and declined to answer further questions. He stated the company is committed to “the highest standards of care.” The Winn Parish Sheriff’s Office and the Winn Parish Coroner’s Office did not respond to requests for comment. Medical examiners have identified diabetes as a contributing factor in at least six of the ICE detainees’ deaths during Trump’s second presidency. Detainees with diabetes have frequently raised concerns in court about inconsistent access to insulin and other medications. These deaths have drawn increased scrutiny of ICE detention facilities, with critics accusing them of neglecting medical care and subjecting detainees to inhumane conditions — claims that ICE denies. According to a June report by the Department of Homeland Security’s Office of Inspector General, an unannounced inspection at Winn found violations of standards related to medical care, food service, and use of force. Issues included improper storage of frozen food and failure to maintain updated medical records, which could negatively affect detainee health and safety. 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 monitoring 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 The Associated Press, speaking in Spanish from Costa Rica. His health reportedly worsened about two weeks prior when he was in an immigration detention center in Michigan and was placed 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 eat or drink, including because the food was sometimes spoiled. It was not known if he had an underlying heart condition. He also spoke with Luis Herrera Andy, a Honduran man detained in the adjacent cell, who noted that Marchena received irregular insulin shots. A doctor gave Marchena pills for his chest pain, but he returned angry, Herrera said, recalling Marchena’s 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. He was a pale purple color and wet with sweat. Hours before his death, his girlfriend, Ana Leon Castro, said he called around midnight to report that 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 in a diabetic person due to too little or too much insulin, said Garg at Harbor-UCLA. Symptoms like vomiting, headaches, nausea, and stomach pain can indicate a life-threatening insulin deficiency, though other causes, such as an infection, may also be involved. Marchena leaves behind four children. According to ICE, he entered the U.S. without legal status in February 2021. ICE stated that Marchena had prior misdemeanor convictions for retail fraud and property destruction before being arrested in January by the Ottawa County Sheriff’s Department in Michigan for assault. In July, an immigration judge ordered his deportation, according to the Department of Homeland Security. 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 to questions about the denial.