Health issues or legal strategy? Defense and prosecutors clash over Cilia Flores’s condition

The same week Delcy Rodríguez was received in New York as Venezuela’s interim ruler and met with Donald Trump in Manhattan, the U.S. Attorney’s Office opposed releasing Cilia Flores, wife of deposed Venezuelan president Nicolás Maduro, on bail from the Metropolitan Detention Center in Brooklyn, where both have been held since the January U.S. military intervention in Caracas.

While Rodríguez was in the halls of the United Nations General Assembly, Flores was sharing a cell with about 40 other women while, her lawyers have said in court filings, suffering from heart and gastric problems, weight loss, and dental issues. Flores is also recovering from a head wound sustained during the operation in which she was arrested alongside Maduro on January 3.

This month Flores’s defense asked that, for health reasons, she be allowed to await trial out of custody; the trial is scheduled to begin on June 1, 2027. In their petition they argue that Flores should be recognized and treated as the “First Lady of Venezuela, at least de facto,” just as Rodríguez, Maduro’s vice president, has been recognized by the United States and the international community as the country’s interim leader.

The U.S. Attorney’s Office opposes the request and contends that, if Flores’s health has worsened during her nine months in detention, it is because she has refused medical treatment. “Essentially, she has created a medical difficulty that she now uses as a basis to seek release,” the prosecutors say in court filings, which are one of the few windows into the proceedings and the daily life of Flores and Maduro at the Brooklyn detention center.

“The defendant has repeatedly, for months — against medical recommendations — refused to undergo a routine diagnostic procedure that would allow health professionals to better determine any additional treatment necessary for her cardiac condition,” the U.S. Attorney’s Office says in its opposition memorandum to the request.

No definitive diagnosis

Cilia Flores’s health had already been discussed at the second initial federal court hearing held in March of this year. At that time, Judge Alvin Hellerstein ordered that Flores undergo medical exams to evaluate her heart health. Defense and prosecutors’ filings state that Flores had a stress test on April 23 at the Brooklyn Hospital Center. Three cardiologists examined her, one of whom spoke Spanish, and they recommended a catheterization to reach a definitive diagnosis.

Flores has refused to undergo the procedure and her lawyers say she will not agree to it until she can be released on bail and recover under house arrest. In the memorandum supporting their request, the lawyers also describe injuries sustained during the U.S. incursion in Caracas. “During the military operation, Mrs. Flores de Maduro was thrown against a wall or a dresser and suffered significant forehead injuries that required about 20 stitches, as was recorded at her initial appearance on January 5, 2026,” the filing says.

They also note that Flores had no major health problems before her detention but was recovering from surgery and had for years been receiving a monthly injection to treat “mitral valve prolapse,” a condition that prevents the valve that controls blood flow to the heart from closing uniformly. “Mrs. Flores de Maduro was recovering from a total hysterectomy performed in November 2025. She had been advised to limit her movements for at least three months, which included bed rest at home, avoiding physical exertion from exercise, and limiting walking to the minimum within the home.”

The filings say that since her detention Flores has been prescribed four medications, including children’s aspirin, to relieve chest pain when necessary. The lawyers say she has suffered reflux and gastritis, has lost two molars and more than 25 pounds, and has not received the monthly injection for mitral valve prolapse treatment since her incarceration.

In response, the U.S. Attorney’s Office says Flores has had access to health services and that to date no physician has determined she needs cardiac surgery, including doctors retained by her own defense. The office adds that reaching such a conclusion would require the diagnostic test she refuses to undergo.

Flight risk and danger to New York

For the U.S. government, granting bail to Flores would risk her fleeing or maintaining contacts with networks in Venezuela that, the indictment alleges, enabled her to run narcotics trafficking and narco-terrorism operations. “The defendant represents an extreme risk of flight and a danger to the public,” the prosecutors argue.

To oppose house arrest, they note that Flores is a citizen of a country that does not extradite its own nationals, that she has no ties or legal status in the United States, and that she appears to have access to “substantial wealth.”

The prosecutors’ case to show how dangerous Flores is describes episodes in which she and her husband allegedly used state security agencies and paramilitary groups known as colectivos to commit violence and intimidation.

“Even if the defendant is no longer in Venezuela, the real risk would remain that, if released, she could communicate with her accomplices in that country — or otherwise direct them — to target witnesses and victims of the conspiracy,” the opposition memorandum to bail states.

Finally, the U.S. Attorney’s Office also says that placing Flores under house arrest with private security guards, as the defense suggests, would pose a danger to New Yorkers: “Any attempted escape would carry the risk of an armed confrontation between guards and the defendant (or her followers) on the streets of New York City.”

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