The death of an Afghan man who fought alongside US Special Forces before resettling in the United States has been ruled an accident after he suffered a fatal allergic reaction while in Immigration and Customs Enforcement (ICE) custody.

According to a death certificate, 41-year-old Mohammad Nazeer Paktiawal died on March 14 after experiencing an adverse reaction to an unidentified substance that triggered anaphylaxis and aggravated his asthma. He died at a hospital in Dallas, Texas, one day after being detained by ICE as part of deportation proceedings.

The ruling has intensified calls for greater transparency surrounding Paktiawal’s death, with advocacy organizations, lawmakers and family members demanding the release of the full autopsy report.

Paktiawal had served alongside U.S. Special Forces in Afghanistan for around a decade before being evacuated to the United States during the 2021 withdrawal of American troops. He entered the country legally and had an asylum application pending when ICE officers arrested him at his Texas home on March 13.

According to ICE, Paktiawal underwent a medical screening after arriving at a detention facility and did not report any medical conditions or allergies. Hours later, he complained of chest pain and difficulty breathing before being transferred to Parkland Memorial Hospital.

Hospital staff later observed swelling of his tongue while he was eating breakfast and administered epinephrine, the standard emergency treatment for severe allergic reactions. Despite efforts to revive him, he was pronounced dead approximately 40 minutes later.

The death certificate lists the cause of death as “anaphylaxis complicating acute asthma exacerbation.” It also identifies methamphetamine toxicity, heart disease and cigarette smoking as contributing factors.

However, Paktiawal’s relatives dispute suggestions that he used methamphetamine. His family commissioned an independent autopsy, but experts were reportedly unable to determine whether the drug was present because no blood samples remained for further testing.

His wife has also said Paktiawal suffered from asthma and relied on an inhaler, claiming ICE officers refused to allow her to hand him the medication when he was taken into custody.

The circumstances surrounding his death have prompted criticism from Afghan refugee advocates and members of the U.S. Congress.

Shawn VanDiver, president of the advocacy group AfghanEvac, questioned what substance caused the fatal allergic reaction and called for authorities to release the complete autopsy findings.

“This family has a right to know what happened,” VanDiver said.

U.S. Senator Richard Blumenthal also urged the Department of Homeland Security to make the autopsy public, saying there were serious unanswered questions surrounding the case.

Dallas County officials have so far declined to release the report, arguing that disclosure could interfere with an ongoing federal criminal investigation. Texas Attorney General Ken Paxton’s office is reviewing the request to withhold the document under the state’s public records law.

ICE has defended its decision to detain Paktiawal, citing previous arrests on food stamp fraud and theft allegations. However, he had not been convicted in either case.

Paktiawal’s death has resonated widely within the Afghan-American community, where many remember him as a soldier who risked his life supporting U.S. forces during the war in Afghanistan before rebuilding his life in America as a truck driver and father of six.

His case is the first death in ICE custody during President Donald Trump’s second term to be officially classified as an accident. Most other deaths recorded during the period have been attributed to natural causes or suicide.