An Afghan man who once fought beside U.S. forces died in Immigration and Customs Enforcement custody from an allergic reaction just one day after he was detained for deportation proceedings, according to his death certificate.
Mohammad Nazeer Paktiawal, 41, experienced “an adverse drug reaction” to an unidentified substance, the document says. The reaction caused anaphylaxis and worsened his asthma. His death on March 14 at a Dallas hospital was ruled accidental.
The circumstances of Paktiawal’s death have prompted anger and calls for transparency, in part because he spent a decade serving as an ally to U.S. Special Forces in Afghanistan. Lawmakers and AfghanEvac, an advocacy organization, are pressing officials for a clearer account of what happened while he was in custody.
According to tracking by The Associated Press, Paktiawal’s death is the first among more than 50 ICE detention deaths during President Donald Trump’s second term to be classified as an accident. Most of the other deaths have been attributed to natural causes or suicide.
On Monday, AfghanEvac urged Texas authorities to make his full autopsy report public. Officials have sought to keep the report from being released, arguing that disclosure could interfere with an ongoing criminal investigation into the death.
“This family has a right to know what happened. Why won’t they release the report?” said Shawn VanDiver, president of AfghanEvac. He said authorities should identify the substance that triggered the allergic reaction, explain how it entered Paktiawal’s system and clarify why the death certificate lists the date of injury as the day before he was taken into custody.
Paktiawal was among the thousands evacuated from Afghanistan after U.S. troops withdrew in 2021. He entered the United States through a legal process and applied for asylum. That request was still pending when ICE agents arrested him at his home in Richardson, Texas, on March 13 as he was taking some of his six children to school.
ICE has stood by its decision to place Paktiawal in deportation proceedings, citing arrests on food stamp fraud and theft charges. He had not been convicted in either case.
A one-page ICE report on Paktiawal’s death said that he was screened at its Dallas field office and denied any medical conditions or allergies. Hours later, he began experiencing shortness of breath and chest pain in a holding room and was taken to Parkland Memorial Hospital.
The next morning, hospital staff noted swelling of his tongue while he was eating breakfast and gave him epinephrine, a drug that treats allergic reactions, the report said. He was pronounced dead about 40 minutes later after life-saving measures were unsuccessful.
The certificate lists the cause of death as “anaphylaxis complicating acute asthma exacerbation.” Anaphylaxis is a severe allergic reaction typically triggered by food, drugs or insect venom. The document lists the toxic effects of methamphetamine, heart disease and cigarette smoking as contributing factors in the death.
His family members and coworkers said they did not know Paktiawal to use meth, and a private autopsy performed for the family could not confirm whether he had meth in his system because no blood remained for testing, VanDiver said. His wife has said that he relied on an inhaler for asthma, but ICE agents rejected her attempt to give them the device when he was taken into custody.
The cause and manner of death were established by the Dallas County Medical Examiner’s Office, where a doctor performed an autopsy on Paktiawal.
County authorities have refused to release the autopsy report, citing statements from ICE officials that doing so would interfere with a federal investigation into the death. They have asked Texas Attorney General Ken Paxton’s office for permission to withhold the record under a “law enforcement exception” to the state’s open records law.
In response to the AP’s request for the report, Dallas County official Jennifer Rose wrote that “its release would interfere with the detection, investigation, and prosecution of a crime” but did not elaborate. The medical examiner’s office declined comment.
Paxton’s office hasn’t ruled on the matter, but previously granted a similar request from another Texas county to withhold the autopsy report of a Vietnamese man who died in ICE custody in July 2025, according to documents obtained by the AP.