SCOTTSDALE, ARIZONA — The Maricopa County Medical Examiner's Office has listed the primary cause of death for Immigration and Customs Enforcement detainee Emmanuel Damas as "Complications of Necrotizing Mediastinitis with Neck and Retropharyngeal Abcess in the setting of Severe Dental Caries and Peridontal Disease." The report lists the manner of death as "natural."

Damas, 56, died on March 2 in a hospital in Scottsdale, Arizona. He had been taken into custody in September and remained detained until his death.

ICE said Damas was transported to the hospital on February 19 after complaining of shortness of breath while at the Florence Detention Center in Florence, Arizona. In a March 6 statement, the agency said he had been tested at the hospital and had been in the hospital's intensive care unit throughout his stay. The statement did not mention concerns Damas raised about his teeth or whether he requested dental treatment.

An operator at the medical examiner's office said a preliminary report had not yet been issued and that reports are not released for 90 days. The final report is scheduled to be issued later this month.

Damas' brother, Presly Nelson, told the Associated Press that Damas died from an untreated tooth infection. He said his brother was fine before he was detained and had periodically undergone routine dental care but did not have serious issues. In the last week he spoke with his brother, Nelson said, Damas was complaining about a toothache.

A person who had befriended Damas while they were both detained called Nelson to say Damas was not doing well and had been taken to the hospital, he said. According to Nelson, the friend said Damas had been complaining of a toothache and received ibuprofen from a nurse at the detention facility.

"At no point did we think this would happen. The last time I spoke to him, had I known that would have been the last time, I would have made it a more meaningful conversation," he said.

Rep. Adelita Grijalva said the findings raise more questions about Damas' medical treatment while in custody. She said she had formally requested his medical records, records of complaints to staff and a full accounting of the circumstances leading to his death. "The full records, transparency or accountability that his family deserves," Grijalva said her office has not received.