An unaccompanied 15-year-old migrant girl from Guatemala died on Monday from an underlying disease while in federal custody, according to officials.

This marks the fourth death of a child in U.S. government custody this year.

The girl had been hospitalized at El Paso Children’s Hospital for a significant, pre-existing illness when she was referred from the U.S. Department of Homeland Security to the Office of Refugee Resettlement in May, the U.S. Department of Health and Human Services said in a statement Tuesday.

The girl was provided medical treatment “according to the mother’s wishes and aligned with the recommendations of the hospital’s health care provider team,” the statement said.

The girl’s condition deteriorated Friday, and she died Monday as a result of multi-organ failure due to an underlying disease, officials said. Officials said her mother and brother were with her when she died and in the days leading up to her death.

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The national flag of Guatemala flies at the embassy of the South American country on May 13, 2023 in Brussels, Belgium. 

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Officials did not release the girl’s name or say when she had entered the country.

In May, a 17-year-old boy from Honduras died in U.S. custody. Ángel Eduardo Maradiaga Espinoza died at a holding center in Safety Harbor, Florida. His mother said her son had epilepsy but showed no signs of being seriously ill before he left for the United States.

Days later, an 8-year-old girl from Panama who had a history of heart problems and sickle cell anemia died while she and her family were in custody of Border Patrol in Harlingen, Texas. The mother of Anadith Danay Reyes Alvarez said agents repeatedly ignored pleas to hospitalize Anadith as her daughter felt pain in her bones, struggled to breathe and was unable to walk.

In March, a 4-year-old “medically fragile unaccompanied child from Honduras” died at a hospital in Michigan, according to a Health and Human Services statement at the time.

The deaths raised questions and scrutiny over the qualifications of U.S. agents to handle medical emergencies by migrants in their custody.