An Afghan national who had worked alongside U.S. forces for more than a decade died from an allergic reaction while in Immigration and Customs Enforcement custody, according to his death certificate released this week. Mohammad Nazeer Paktiawal, 41, suffered an adverse drug reaction to an unidentified substance that triggered anaphylaxis and worsened his asthma, the document shows. His death at a Dallas hospital on March 14 was ruled an accident.
Paktiawal’s sudden death in ICE custody has drawn widespread outrage because he had risked his life fighting as an ally of U.S. Special Forces in Afghanistan for a decade. Members of Congress and the advocacy group AfghanEvac have demanded answers about what happened to the father of six. Out of more than 50 ICE detention deaths during President Donald Trump’s second term, Paktiawal’s is the first to be ruled an accident.
The death 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 also lists the toxic effects of methamphetamine, heart disease and cigarette smoking as contributing factors in the death. However, his family members and coworkers said they did not know Paktiawal to use methamphetamine, and a private autopsy performed for the family could not confirm whether he had meth in his system because no blood remained for testing.
Paktiawal was arrested at his home in Richardson, Texas, on March 13 as he was preparing to take some of his six children to school. His wife attempted to give him an asthma inhaler he relied on, but ICE agents rejected her attempt to provide the device. He had been detained for less than a day when he died.
According to ICE, Paktiawal was screened at its Dallas field office that morning and denied any medical conditions or allergies. Hours later that evening, he began experiencing shortness of breath and chest pain in a holding room and was transported to Parkland Memorial Hospital. The next morning while eating breakfast, hospital staff noted that his tongue had become swollen and administered epinephrine, a drug that treats allergic reactions. Despite multiple lifesaving efforts, Paktiawal was pronounced dead at 9:10 a.m.
Paktiawal was evacuated from Afghanistan along with thousands of others when U.S. troops pulled out in 2021. He entered the United States through a legal process and requested asylum to stay. That claim was pending when ICE arrested him. ICE has defended its decision to target him for deportation, noting he had been arrested on food stamp fraud and theft charges. He had not been convicted in either case.
Shawn VanDiver, president of AfghanEvac, has called on authorities to explain what substance triggered the allergic reaction, how it got into Paktiawal’s system and why the date of the injury on the death certificate was listed as the day before he was taken into custody. “This family has a right to know what happened. Why won’t they release the report?” VanDiver said.
County authorities have refused to release the full 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. Paxton’s office has not yet 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.
The Homeland Security Department has said no one in ICE custody is denied access to proper medical care. A department spokesperson stated that the agency provides comprehensive medical care from the moment individuals arrive and throughout their stay, including medical, dental and mental health services.
Paktiawal’s death has raised questions within the Afghan community and among veterans who served alongside Afghan forces. His family released a statement saying they were trying to comfort six children who had lost their father. “His children watched as he was surrounded and taken away. That moment will stay with them forever,” the statement said. According to the family, Paktiawal was the sole provider for his household and had worked at a halal market in the Dallas area while his asylum case remained pending.