A man showing flu symptoms has become the fourth and latest person in recent months to die in Immigration and Customs Enforcement custody, officials announced on Friday.

Abel Reyes-Clemente, 54, was handed over to the agencys Florence Service Processing Center in Arizona after being released from Maricopa County Jail in February, where he was serving time for a misdemeanor DUI conviction. He was last deported in 2008, for the fifth time, eventually returning to the U.S., the agency said.

On Monday, Reyes was placed into medical observation at the SPC after presenting signs and symptoms of influenza , ICE said. By Wednesday morning, facility personnel found Mr. Reyes unresponsive and not breathing, the agency added.

According to the agency, the ICE Health Service Corps was then alerted and medical staff and paramedics responded, attempting without success to resuscitate Reyes. Within 21 minutes, it said, he was declared deceased by the Mountain Vista Medical Center.

An autopsy will determine the cause of death, ICE said.

In its statement, the agency emphasized the more than $269 million it spends each year on health care, asserting that it provides necessary medical attention to those who need it:

Comprehensive medical care is provided from the moment detainees arrive and throughout the entirety of their stay. All ICE detainees receive medical, dental and mental health intake screening within 12 hours of arriving at each detention facility, a full health assessment within 14 days of entering ICE custody or arrival at a facility, and access to daily sick call and 24-hour emergency care.

Reyes death follows three others that occurred in November, including those of a Cuban man and two Russians, one of whom appears to have died by suicide, according to an agency report .

In December, two children died in Border Patrol custody after experiencing vomiting, among other symptoms. One was 7 years old and the other was 8. Since then, two adults have died while being held by Border Patrol.

Despite ICEs claim that it offers adequate medical care to detainees, last June, a Human Rights Watch investigation of government records on deaths from December 2015 to April 2017 led the organization to conclude that of 15 cases, poor medical care contributed to at least eight of the deaths.

During that 17-month span, a total of 16 people died, meaning HRW found that substandard care played a role in half of them.