Requests to go to the hospital were frequently turned down for an eight-year-old girl with underlying medical issues who passed away while in the care of the US Border Patrol.

Nine times over the course of three days, Anadith Tanay Reyes Alvarez was examined by medical personnel for “fever, flu-like symptoms, and pain,” according to the investigators.

On the day of her death, a nurse saw her four times.

The nurse, however, refused “three or four requests from the girl’s mother for an ambulance to be called”.

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Customs and Border Patrol, which has produced a report about Alvarez’s death, provided details of the incident.

On May 16, ice packs, a cold shower, and flu medication were used to treat the girl’s symptoms. She was born in Panama to Honduran parents.

However, none of the professionals appeared to be aware that Alvarez had a history of congenital heart problems or that she had sickle cell anemia, a condition that often requires lifelong therapy.

The family claimed that when they were first taken into custody at a separate institution a week earlier, they had disclosed her medical history.

According to agency regulations, detention should not last more than three days; however, because typical processing durations have significantly increased in recent years, this is frequently not the case.

After the girl tested positive for the flu, the family was moved to the Harlingen facility, where Alvarez died, for medical isolation. Investigators have pieced together events from interviews even though the facility’s CCTV had been down for some weeks.

It stated that a different medical team member claimed to have brought “a pile of documents” and some folic acid tablets to the nurse the morning the girl passed away from her injuries. Vitamin B9, commonly known as folic acid, can be used to cure anemia.

Alvarez was given one tablet by the nurse, but according to CBP, she “refused to review the papers.”

At that point, her symptoms had gotten worse and included nausea, breathing difficulties, and stomach aches.

After the fourth visit to the nurse that day, hours later, Alvarez’s mother returned with her daughter, who appeared to be experiencing a seizure, in her arms. Emergency services were contacted at that time, but the eight-year-old was pronounced dead an hour later.

The account provided by the agency seems to corroborate information from an interview her mother, Mabel Alvarez Benedicks, had with the Associated Press a few days after her daughter’s passing.

She told AP, “They killed my daughter because she had been unable to breathe for almost a day and a half.” They ignored her as she sobbed and begged for her life. They did nothing to help her.

According to the CBP’s preliminary examination, the medical staff allegedly never discussed Alvarez’s condition with any medical professionals, including an on-call pediatrician.

The small girl’s autopsy revealed a collection of fluid in her chest cavity and highlighted “the attempted surgical repair of the girl’s aortic stenosis” (a cardiac problem), as well as the history of sickle cell anemia that was given. It has not yet been formally determined what caused the death.

Troy Miller, the interim director of CBP, called her passing “a deeply upsetting and unacceptable tragedy” in a separate statement on Thursday.

He added that “a number of the medical professionals involved in this incident are no longer permitted to work in CBP facilities.”

Efforts had been made to assess the situations of “all medically fragile individuals,” he noted, and the agency’s senior medical officer was reviewing protocols at all of its sites.

After a 17-year-old Honduran boy, ngel Eduardo Maradiaga Espinoza, passed away in a shelter in Florida run by the Department of Health and Human Services’ Office of Refugee Resettlement, Alvarez’s death marked the second juvenile death in detention in just two weeks.