Vol. 9, No. 8 October 1998
Men Behaving Really Badly
Safe and legal safe and legal safe and legal. Such has been the constant refrain of the pro-abortion lobby. Abortion advocates have convinced much of the country that they are the guardians of women's health and safety, just as they are the guardians of women's "rights." Yet even a cursory look at litigation since Roe v. Wade shows that abortion advocacy groups, like Planned Parenthood and the National Abortion Federation (NAF), have consistently championed the rights of the industry, its clinics and doctors, over the health and safety concerns of women.
In recent months abortion groups opposed the Child Custody Protection Act (CCPA) by raising the specter of back alley abortions. The modest bill, designed to bolster state laws on parental involvement in minors' abortion decisions, was dubbed the "Teen Endangerment Act." The groups claim that teenage girls, unwilling to tell parents of a pregnancy and unable to travel alone to an out-of-state clinic, would be forced to risk their lives turning to unscrupulous, incompetent back alley doctors operating in filthy offices. The CCPA died before enactment, but it is nevertheless worthwhile to test the claim that legal and safe are equivalencies. One need only examine the conduct of abortion providers and clinics recently mentioned in the mainstream press to find out precisely who is endangering whom.
There was a time when you could count on reporters not to know or care much what happened behind clinic doors. But the times are changing for America's abortion practitioners. One little slip-up you misjudge an unborn baby's age by three months, you lose a patient or two to a perforated uterus, you defraud a few insurance companies and BAM! Today's newshounds are baying at your door. Before you know it, reporters are digging into your whole sordid history: malpractice claims, hearings before state medical boards, censures, suspensions, OSHA violations. As if the notoriety weren't bad enough, the era of tolerant medical examiners (key phrase: "perforations happen") is ending. Now they're beginning, occasionally, to hold abortionists to standards approaching those of the rest of the medical profession.
An attorney defending California abortionist Gordon Goei posted an Internet plea on the WHAM (WomenUs Health Action & Mobilization) ALERT! website for corroborating evidence that "physicians who perform later abortions are under attack from the California Medical Board." But who needs a conspiracy theory when abortionists from one end of the country (e.g., New York, New Jersey and Georgia) to the other (e.g., Arizona and California) are behaving so badly?
Case in point: John Biskind of the A-Z Women's Center in Phoenix. Recall that last June, while attempting to do a partial-birth abortion on a baby whose age he estimated at 23.6 weeks, Dr. Biskind discovered the little girl to be nearly full-term, weighing 6 pounds, 2 ounces. He delivered her intact, but not before he had fractured her skull and deeply lacerated her face in two places. No one died. No big deal, if not for the unwelcome exposure it brought to Dr. Biskind and the clinic. It wasn't long before inquiring reporters unearthed a few hoary skeletons. And now, the rest of the story:
In addition to "letters of concern" from the Arizona Medical Board (AzMB) for sending a patient home mid-abortion when he discovered her "10-week old" fetus was late-term, and for signing blank, undated prescription forms the AzMB found gross negligence in the 1995 death of a woman whose uterus was torn 8 cm (more than 3") during a 20+week abortion. And in April 1998 Dr. Biskind aborted the 26-week unborn child of Louann Herron, although Arizona prohibits abortions at 26 weeks and beyond, absent documented risk to the mother's life or health. Victoria Kimball, an RN then employed by A-Z Women's Clinic, states that Dr. Biskind knew of the baby's age from two prior ultrasounds, but instructed an assistant to take another ultrasound from a different angle to make the baby appear younger than 24 weeks. After viability (23-24 weeks), Arizona requires that a second physician be present to care for the child if a live birth occurs, and mandates that a fetal death certificate be filed.
The abortion was completed at 12:40 p.m. and Ms. Herron was taken to a recovery room. No doctor and no nurse was present. One and a half hours later, alarmed medical assistants (two of whom were new and untrained) alerted Dr. Biskind that the patient was still bleeding. He ordered medication to control the bleeding and left the clinic for the day. Hours later frantic assistants called 911. Paramedics gave CPR, but it was too late to save Ms. Herron. The AzMB was still investigating this incident when Dr. Biskind finally earned his 15 minutes of fame by miscalculating another baby's age by almost 3 months.
Scratch a little deeper and you find that: County Court records show seven lawsuits that name Biskind, the A-Z clinic or Dr. Moshe Hachamovitch, the clinic's owner. The A-Z clinic also was fined for 12 health hazards in 1996 by the Occupational Safety and Health Administration.
Two lawsuits and complaints against Dr. Hachamovitch arise from the deaths of patients from abortions in his Texas and New York clinics. A 15-year-old girl underwent an abortion at his Houston A to Z Women's Services in February 1994. Four days later she was admitted to a hospital with symptoms of blood poisoning fever, chills, abdominal pain, and nausea. Doctors found a cervical tear and post-abortion infection. Despite intensive treatment, she died on March 2 from the infection.
Another case in point: Recent press reports have exposed Dr. Steven Brigham's systematic insurance fraud and tax evasion, for which he was sentenced to 120 days in jail, five years' probation and restitution. But they don't mention that he lost his medical licenses in Pennsylvania, New Jersey, New York, Georgia and Florida for acts committed within each state (including life-threatening botched abortions).
Notwithstanding his New York license revocation, Dr. Brigham continued to operate clinics in Colonie (a suburb of Albany, N.Y.) and Nanuet, about 15 minutes north of New York City. He also performed second trimester abortions in New Jersey despite a 1994 order from the N.J. medical board limiting him to first trimester abortions (up to 14 weeks).
The complaint against Dr. Brigham before the N.J. State Board of Medical Examiners alleges that he committed "repeated acts of negligence, gross negligence, malpractice or incompetence, and engaged in the use of dishonesty, deception, or misrepresentation as well as professional misconduct" (Interim Decision and Order, Feb. 7, 1994). In May 1992, while aborting a 24-week child at the Flushing Women's Center, Dr. Brigham perforated the mother's uterus, failed to recognize the complication and "inflicted extensive damage on the patient, jeopardizing the patient's life and health. The patient was transferred by ambulance to a hospital for emergency surgery to repair an 8-10 cm [3-4 inch] uterine laceration, bilateral pelvic peritoneal lacerations, disruption of the sigmoid mesentery, transmural laceration of the sigmoid colon and extensive damage to both ureters" (Interim Decision and Order).
In November 1993, Dr. Brigham lacerated the uterus of a 20-year-old woman at his Spring Valley, N.Y. office during the abortion of her 26-week child. The patient vomited, passed out, and bled severely for three hours before being taken to a hospital, in shock, where an emergency hysterectomy was performed.
Brigham's alter ego in New York, Dr. Mark Binder, did abortions at Brigham's clinics in Colonie and Nanuet. A Statement of Charges against Dr. Binder by the N.Y. State Board of Professional Medical Conduct (Sept. 1996) alleges eighteen specifications of gross negligence, gross incompetence, conduct evidencing moral unfitness, and fraud.
Binder instructed an ultrasound technician to falsify readings on gestational age so that fetuses over 24 weeks would appear to be under New York's legal age limit.
Binder scheduled a patient for an illegal third-trimester abortion (26-27 weeks) at the Nanuet clinic for the first day's insertion of laminaria and the Colonie clinic (150 miles away) for the second insertion of laminaria on the following day. The procedure was scheduled the third morning in Colonie. When Binder found himself unable to complete the abortion, and having no hospital privileges or back-up physician in the Albany area, he made the patient wait two hours (with no further examination or monitoring) while he saw to the rest of the morning's abortions. He then instructed the patient's husband to drive her to Beth Israel Hospital in New York City, accompanied by a staff member with limited medical training. In addition to his grossly negligent treatment of the patient, Dr. Binder was found to have made false statements and records at every step. Based on these and other findings, his N.Y. license was revoked and he was fined $25,000.
Reproductive Health Care in the Style of Hieronymus Bosch
Not convinced yet? You may think that while the four doctors mentioned above, and their numerous clinics, may have been unsafe, may have cost women their lives or health, they fall into the category of rogue "chop shops" (in the parlance of a California ob/gyn). Perhaps they're not representative of the industry, of the big-name, established facilities. Surely a woman would be safe going to, say, Midtown Hospital, the largest abortion clinic in Georgia. Midtown is (or was) an NAF member, got Planned Parenthood referrals, and is advertised on the attractive Abortion Clinics Online (ACOL) website as well as the website for the National Coalition of Abortion Providers. Midtown's posting has this to say about its quality service:
"Midtown Hospital has stood for quality healthcare since its founding in the early 1900s. ... In 1977, the focus of that outstanding care changed when Midtown Hospital became a women's medical facility offering a full spectrum of gynecological healthcare services and the tradition of unsurpassed excellence remained. ... Today, Midtown Hospital is a rare facility, providing the medical profession and patients with nationally-recognized programs in second trimester abortions for medical and genetic studies. ... Midtown is an invaluable resource to referring universities, hospitals and private physicians. ... Every abortion is overseen by a Board Certified pathologist. Whether a patient is treated as an out-patient or is admitted for an overnight stay, she receives experienced, professional care in a warm and comfortable environment. Although Midtown Hospital strives to maintain reasonable costs, the staff never cuts corners on laboratory tests, medical care, counseling, personal attention or follow-up care. Midtown Hospital is licensed by the State of Georgia. All physicians are Board Certified and all other medical staff are fully licensed. In addition, our staff is trained in and dedicated to meeting the personal, emotional and physical needs of our patients. It is in this spirit that we preserve the dignity of our patients and provide uncompromised medical care in an atmosphere of comfort and caring." (Emphasis supplied.)
Cue "America the Beautiful" and fade ... and cut! A perfect ad for all that's best in reproductive healthcare.
Unfortunately, a complete sham. But only the victims (e.g., 7,465 clients in 1996) knew the conditions as, for more than two years, the Georgia Department of Human Resources allowed Midtown to continue to operate despite repeated on-site investigations which showed "a complete disregard for, or the inability to care for, the health and safety of its patients" (Verified Complaint for Injunctive Relief filed May 20, 1998). On May 22, 1998 Midtown Hospital was temporarily closed by a Superior Court judge pending the outcome of litigation to shut it permanently. Were it not for a short account of the clinic's closing in the Local News section of The Atlanta Journal-Constitution (May 23), no one would be the wiser.
For the full story, one has to turn to court records. Paragraph 2 of the Complaint against Midtown neatly summarizes the charges.
[Warning: Graphic material not suitable for children]
"Inspections of Midtown Hospital by DHR staff, interviews with current and former employees of Midtown Hospital, and interviews with women who have been patients at Midtown Hospital reveal an overcrowded, understaffed and dirty health care facility that jeopardizes the health and safety of its patients. For example, overcrowding and lack of proper monitoring of patients results in the expulsion of fetuses on the floor and in the commode of the preoperative area; Midtown Hospital's sterilization process to prevent the spread of infection is severely deficient; Midtown Hospital's personnel files lack any evidence that many of its employees are qualified for their jobs; and Midtown Hospital lacks any system for identifying, documenting, or evaluating unexpected or negative patient outcomes. DHR staff has consistently found that Midtown Hospital's records lack information regarding transfer of patients to other facilities due to complications arising during or after surgical procedures performed at Midtown Hospital."
Details are fleshed out in the Brief supporting the Motion:
"It is Midtown Hospital's practice to administer the oral medication Cytotec and intravenous Pitocin, which induce labor, to second trimester patients early in the morning on the day of the surgical procedure. ... The patients then sit in the pre-operative room until their surgical procedure. ... Thus, Midtown Hospital lacks a system to assure a relationship between the time of the administration of the labor-inducing medications and the time of the surgical procedure."
Perhaps this deficiency can be better appreciated through the more concrete testimony of patients and employees. According to the Affidavit of "Employee A," employed at Midtown Hospital from November 1996 to February 1998:
"The preoperative room is located near the room where I was stationed. I could hear the patients hollering and screaming in the preoperative room. ... I saw patients laying on the floor crying in pain. ... I routinely saw patients expel fetuses on the floor and in the commode in the preoperative room. Patients expelled fetuses in front of other patients that were awaiting procedures. Patients expelled fetuses in commodes that were used by other patients. ... I regularly observed patients expel fetuses in the commode in the discharge area. ... Oftentimes, I was the only staff member in that area to assist patients. I do not have medical training."
Employee B is a certified surgical technician, employed at Midtown Hospital from March 30, 1998 until resigning on April 18, 1998. His/her Affidavit provides a similar chilling description of Midtown's patient care:
"On April 18, 1998, at approximately 7:00 a.m., I witnessed a patient deliver an intact fetus in the toilet of a bathroom in the waiting room area. After expelling the baby and the afterbirth, the patient walked to the operating room because there were no wheelchairs. I opened the fetal sac so that the fetus could be weighed. The weight was approximately 3029 grams [over 6 pounds, 10 ounces!]. It was a very big fetus. My impression is that at Midtown Hospital a procedure will be done at any gestational age as long as the patient has the money. I witnessed patients frequently expelling fetuses on the floor and in the toilet. It happened frequently throughout each day the abortion procedures were done. ... Women are allowed to expel fetuses whenever and wherever with no concern for the patient. When I would attempt to comfort the women, I was told that this was not my job."
As might be expected, other aspects of patient care were equally substandard. The Affidavit of Employee B continues:
"I never saw the doctors or the anesthesiologist do any pre-operative work-ups on the patients prior to the patients going into the operating room. ... Sterilization standards are not followed. ... Most women lay on the floor in the pre-op area. Once I attempted to get some sterile sheets for the patients to lay on and was told by the Operating Room supervisor that if "they can lay up and get pregnant then they can come in here and deal with the procedure." I have witnessed the use of stretchers with blood and bodily fluids on them being re-used without being cleaned. The staff was not concerned about cleaning up blood and other bodily fluids from the floors, chairs, stretchers and bathrooms and did not do so."
The Affidavit of Patient X describes her experience on April 16, 1998. Following her procedure, she experienced "extreme pain ... nausea, vomiting and even more pain." This continued for several days. She called Midtown Hospital at least twice to speak to a doctor or nurse, but was told to make an appointment. Finally, she called 911 and was transported to a local hospital where they diagnosed an incomplete abortion. The Brief refers to other patients who were transfer-red to a hospital for "complications" occurring at Midtown.
One could go on. The DHR inspection reports detail filth, squalor, a lack of sanitation that one might expect to find only in the most poverty-stricken areas of the Third World not at Georgia's busiest abortion facility.
At the risk of "piling on," no discussion of criminal incompetence in the abortion industry would be complete without at least mentioning several California doctors who have been charged with felonies in the past three years.
In 1995 Dr. Suresh Gandotra was charged with involuntary manslaughter for the death of a 23-year-old Mexican woman in the course of a late-term abortion. The "treating physician described her anatomy in medical board records as 'difficult to identify'" (Los Angeles Times, 4/5/98). Gandotra fled the country to avoid prosecution.
Prosecution for second-degree murder is pending against Dr. Bruce Steir for the 1996 death of Sharon Hamptlon who bled to death hours after Steir aborted her 20+ week child, while he was on medical probation and "practicing without oversight from a required proctor" (The [Riverside, Ca.] Press-Enterprise, July 11, 1998). Prosecutors want to intro-duce evidence of similar, though not fatal, "problems" Steir had in the course of abortions in 1988, 1992 and 1993. Authorities charged that one woman nearly bled to death from a lacerated uterus and a ruptured colon. Doctors performed an emergency hysterectomy to save her life. Another patient needed a hysterectomy two days after Dr. Steir perforated her uterus during an abortion. Surgeons found the head of her incompletely-aborted child sticking through the tear in her uterus. Attempting to excuse his incompetence Steir said, "They were all second-trimester abortions. The patients put themselves at risk by waiting so long" (The [Riverside, Ca.] Press-Enterprise, 12/19/96 and 12/21/96).
Dr. Gordon Goei's license was suspended for failing to pass a competency exam when, on March 19, he aborted the 30-32 week-old unborn child of a 42-year-old woman. After the mother was rushed to the hospital for severe bleeding, police found the mutilated body of "Baby Girl Sandoval" in a dumpster behind Goei's clinic. The County Coroner ruled the child's death a "homicide" due to "blunt force trauma." The District Attorney's office claims that Dr. Goei has more accusations against his license than any other doctor in California. The California Medical Board recommended four times that his license be suspended, and in March 1995 voted to revoke his license based on "negligence, incompetence, and unprofessional conduct" toward nine patients. Their decision was overturned by an Administrative Law Judge.
The doctors and clinics that treat the lives of women so cavalierly are, sadly, not an aberration. There are scores of others like them. This should be a national scandal. The pace of regulatory action is sluggish. Medical boards, district attorneys and judges remain reluctant to punish abortionists for negligence and even criminal conduct. Many state legislatures defend the abortion industry from having to follow any real health and safety regulations, claiming that such regulations would drive up the cost of abortion and thereby make it less accessible to women.
Could anyone disagree that corrective action is needed, and needed urgently? The status quo, which protects industry profits and the abortion license to the detriment of women's health and safety, is certain to perpetuate practices that put women at risk every day.
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