PHOENIX (AP) — An autopsy report released Monday confirmed that the death of a Haitian man after spending months at an Arizona immigration detention facility was related to his dental problems, as a family member had contended.

But the report also said 56-year-old Emmanuel Damas, whose brother previously said had died from an untreated tooth infection, declined recommendations at dental appointments to have his problematic teeth removed.

The Maricopa County Medical Examiner’s Office concluded Damas died from complications of a chest infection with abscesses in his neck and throat area. The cause of death also referred to his severe dental problems.

Damas, who died after being detained at the Central Arizona Florence Correctional Center in Florence, Arizona, is one of at least 51 detainees who have died in Immigration and Customs Enforcement custody since President Donald Trump’s second term began in January 2025.

Like his death, medical examiners have ruled the majority of the others to be from natural causes. Experts have said that many of them are from conditions that are preventable with timely and effective medical care.

His death is the only one in which dental problems have been listed as a cause or contributing factor in three dozen deaths where that information has been released by medical examiners and coroners.

Damas’ autopsy report said he was put on a waiting list after it was recommended during an October dental exam that he get a particular tooth extracted. When his chance to get it removed came three months later, the report said he declined, saying it didn’t hurt anymore.

At a subsequent appointment in mid-February, Damas declined another recommendation to have teeth removed. Days later, when Damas complained of a sore throat and abdominal pain, staff at the detention facility asked that he go to the medical unit, but he refused, according to the autopsy report.

He was transported to a hospital on Feb. 19 for respiratory failure and later sent to other hospitals for a higher level of care. He died on March 2 at a hospital in Scottsdale.

In a statement, Raymond Audain, a lawyer representing Damas’ family, said Damas died because of the failures of ICE and the private corrections company that runs the Florence facility to provide him with basic medical care.

The family also had a private pathologist conduct an autopsy on Damas, though Audain declined a request from The Associated Press for that report.

The county’s autopsy “confirms what Mr. Damas’s family has determined through its own investigation: that Mr. Damas died of sepsis as a result of a descending infection from his head and neck that started with him experiencing tooth pain. Mr. Damas begged prison staff for medical care on numerous occasions including the night before he was hospitalized, but he was ignored,” Audain wrote.

In a statement, CoreCivic, which operates the facility in Florence, said it takes the deaths of detainees at its facilities seriously.

“While we’re unable to share specific information about a detainee’s medical care due to federal privacy laws, we are committed to providing safe, humane and respectful care for everyone entrusted to us,” CoreCivic said. “We take seriously our obligation to adhere to all applicable federal detention standards and will continue to ensure that all detainees receive appropriate and timely medical attention

The AP left a message with ICE seeking comment on the autopsy report.

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Associated Press writer Ryan Foley in Iowa City, Iowa, contributed to this report.