The autopsy was done by Kris Sperry, a former chief medical examiner of Georgia who abruptly retired in 2015 after the Atlanta Journal-Constitution detailed his private forensic science work and probed its potential for conflicts of interests with his official state title.

The autopsy was included as part of a “notice of wrongful death” claim filed by the Transgender Law Center on behalf of Hernandez and her family in advance of a lawsuit it plans to file against federal immigration agencies like ICE and Customs and Border Protection. The notice of claim says the autopsy shows that Hernandez “endured physical assault and abuse while in custody.”

The autopsy said Hernandez was found with deep bruising on her rib cage and deep contusions on her back, which were “indicative of blows, and/or kicks, and possible strikes with a blunt object.” Her wrists showed deep soft tissues and musculature bleeding, which it said were typical of injuries from handcuffs.

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“According to observations of other detainees who were with Ms. Hernandez Rodriguez, the diarrhea and vomiting episodes persisted over multiple days with no medical evaluation or treatment, until she was gravely ill,” Sperry wrote in the report.

Lynly Egyes, the director of litigation of the Transgender Law Center, called Hernandez’s death “entirely preventable.”

ICE declined to comment on the specifics of the independent autopsy report.

“A review of Hernandez’s death conducted by ICE Health Service Corps medical professionals confirmed that she suffered from a history of untreated HIV,” spokeswoman Danielle Bennett said in a statement. “At no time did the medical personnel treating Ms. Hernandez at Cibola General Hospital or Lovelace Medical Center raise any issues of suspected physical abuse.”

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In a release about her death in May, the agency said she was the sixth detainee to die in its custody since October 2017. It said medical staff at the Lovelace Medical Center in Albuquerque had determined that she died from cardiac arrest.

Amanda Gilchrist, a spokeswoman with CoreCivic, which operates the Cibola County Correctional Center, said Hernandez was detained at the center for only 12 hours.

“We’re also committed to providing a safe environment for transgender detainees,” she said in a statement, noting that ICE monitors “conditions and contractual performance” at the detention centers.

R. Andrew Free, a lawyer who is representing Hernandez’s family, said he believes that the alleged abuse happened at the Cibola County Correctional Center.

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“We think that based on interviews, that abuse of that nature definitely would have been noticed by people around her,” Free said. “And based on her medical care, we believe that abuse would have be noticed by medical providers, and that leaves one place where there’s still an information vacuum . . . Cibola.”

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The family released a statement through Free and the Transgender Law Center.

“Roxsana Hernandez was our sister and it was an injustice to have her die the way she did,” the statement said. “For us, her closest family, it’s been extremely painful to deal with. She left with dreams of opening a beauty salon and hopes of helping us out. She fled Honduras because here transgender people are discriminated against. She left with hopes of living a better life.”

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Conditions at private jails have come under increasing scrutiny in recent years. In October, ICE released a report detailing significant issues at a large detention facility, run by GEO Group, in California. The violations included cells with nooses dangling from air vents, detainees losing teeth from lack of dental care and one disabled inmate left alone in a wheelchair for nine days.

Hernandez was part of a caravan of migrants organized by the group Pueblo Sin Fronteras that arrived in early May. According to BuzzFeed, the group said she was first detained in a holding cell known as an icebox because of its frigid conditions.

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She told BuzzFeed that she fled Honduras to escape the discrimination and violence she faced as a transgender woman.

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“Trans people in my neighborhood are killed and chopped into pieces, then dumped inside potato bags,” she told the outlet. “I’m scared of that.”

Clarification Nov. 27: An earlier version of this story said that Kris Sperry, the former chief medical examiner of Georgia, resigned after a newspaper detailed his private forensic science work and probed its potential for conflicts of interests. He retired abruptly.