The Department of Homeland Security’s inadequate medical technology and record-management for the thousands of migrants who pass through its custody are contributing to poor care and even deaths, according to lawsuit records reviewed by POLITICO.

A review by POLITICO of 22 deaths of detainees in Immigration and Customs Enforcement custody between 2013 and 2018 revealed malfunctioning softwareand troubling gaps in use of technology, such as failure to properly documentpatient care or scribbling documentation in the margins of forms. Those reviews echo persistent complaints from experts and advocates for migrants rights who say attention to the medical needs of asylum seekers is indifferent at best. Recent reports indicate that Customs and Border Patrol rejected a CDC recommendation to administer flu shots to people in its custody; two children later died of flu in the agency’s facilities.

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“You can’t take proper care of patients if you don’t document care,” said Stan Huff, chief medical informatics officer at Intermountain Healthcare in Utah, who reviewed the paper trail of many of the deaths for POLITICO.

The publicly released death records are cited in a lawsuit brought by the Southern Poverty Law Center and others in August that alleges that ICE’s “centralized policies, practices, and failures of meaningful oversight” have led to unnecessary death and suffering.

Patients suffer from “delays in medical care, refusals to accommodate disabilities, and nearly constant isolation,” according to the suit. “Conditions in detention are so brutal that many people are forced to abandon viable claims for immigration relief and accept deportation out of a desperate desire to escape the torture they are enduring in detention on U.S. soil.”