Gosnell grand jury: “license abortion clinics as ambulatory surgical facilities”

As the Supreme Court hears a case involving a Texas law mandating that abortion facilities be given the same regulatory treatment as ambulatory care facilities, the Gosnell grand jury report from 2011 reminds us what happens when pro-abortion ideology trumps women’s health. I hope the Justices find this report somewhere amid the many briefs that have been filed in the Texas case.

quote from Gosnell grand jury

Gosnell was in Pennsylvania, but the recommendations of the grand jury are of interest to anyone who cares about public health in any state. From page 248 of the grand jury report, under “Recommendations”: “The Pennsylvania Department of Health should license abortion clinics as ambulatory surgical facilities.”

“The regulation of Pennsylvania’s ambulatory surgical facilities – which run over 30 pages – provide a comprehensive set of rules and procedures to assure overall quality of care at such facilities. The effect of the Department of Health’s reluctance to treat abortion clinics as ASFs was to accord patients of those facilities far less protection than patients seeking, for example, liposuction or a colonoscopy….Gosnell’s facility fell far below the basic, minimum standards of care that any patient having a surgical procedure should expect to receive. There is no justification for denying abortion patients the protections available to every other patient of an ambulatory surgical facility, and no reason to exempt abortion clinics from meeting these standards.”

Does the Texas law at issue today create stronger regulations on abortion providers than on, say, liposuction providers? Based on their questions today, some Justices apparently think so, and they don’t like it. I wonder how many of them would object if they believed the law simply required parity with ASFs.

Today at the Supreme Court of the United States, our nation’s solicitor general argued against the Texas law, calling it an “undue burden.”

The Pennsylvania Family Institute and Council anticipated that argument. Their words: “Ask the women who went to Kermit Gosnell if lower standards for abortion clinics is a good thing.”

From Pennsylvania Family Institute.
From Pennsylvania Family Institute.

 

On this date, 2010: the raid on Kermit Gosnell’s office

Kermit Gosnell (mug shot following arrest)
Kermit Gosnell (mug shot following arrest)

Never forget that abortionist Kermit Gosnell’s crimes were made public by accident. Had federal agents not raided Gosnell’s facility on February 18, 2010 during a drug investigation, he’d probably still be snipping the spines of babies who survived his attempts to abort them and women would still be dying at his so-called “clinic.”

A detective for the local district attorney was looking into reports of foul deeds at Gosnell’s place, but nothing came of that until the drug raid.


A 2016 debate in the New Hampshire House included brief references to the imprisoned Pennsylvania abortionist. One state representative warned that children born alive after attempted abortion need stronger legal protection, lest they die at the hands of someone like Gosnell. Another representative dismissed the warning in a that-doesn’t-happen-here tone. “He [Gosnell] is in jail.”

He’s only in jail because drug investigators stumbled across his filthy facility. Without that drug investigation, Gosnell’s savagery would have remained cloaked. In 2010, Pennsylvania had laws regulating abortion, and didn’t enforce them. Pennsylvania had an abortion-friendly political environment. That left Gosnell unaccountable, with a free hand to use his best medical judgment. His best judgment left women and children dead.

As an aside, consider that New Hampshire has no abortion laws to enforce, aside from parental notification and a partial-birth abortion ban. The Granite State also has an abortion-friendly political environment.

From the 281-page grand jury report on the Gosnell case comes this description of the drug raid that finally kicked the justice system into action. Keep in mind as you read this that in correspondence Gosnell shared with a reporter during a series of jailhouse interviews, the jailed man wrote, “I believed my deeds were in a war against discrimination, disenfranchisement, undereducation and poverty.”

On February 18, 2010, the Federal Bureau of Investigation and detectives from the Philadelphia District Attorney’s Office executed search warrants at the Women’s Medical Society, a clinic operated by Dr. Kermit Barron Gosnell at 3801-05 Lancaster Avenue in Philadelphia. The federal Drug Enforcement Administration (DEA), the Philadelphia Police Department, and the District Attorney’s Dangerous Drug-Offender Unit had been investigating Gosnell and his clinic for months, based on reports of illegal prescription drug activity.

During the drug-trafficking investigation, District Attorney’s Detective James Wood learned from one of the clinic employees that a woman had died in November 2009, following an abortion procedure. Detective Wood discovered other disturbing details about Gosnell’s medical practice. The premises were dirty and unsanitary. Gosnell routinely relied on unlicensed and untrained staff to treat patients, conduct medical tests, and administer medications without supervision. Even more alarmingly, Gosnell instructed unlicensed workers to sedate patients with dangerous drugs in his absence.

Based on this information, Detective Wood believed that further investigation of the woman’s death the previous November was warranted. The detective searched for a police report on the incident, but finding none, he went to the Philadelphia Medical Examiner’s Office to try to identify the woman and to find out more about her death. Detective Wood learned that the dead woman was Karnamaya Mongar, and that her toxicology report revealed an extremely high level of Demerol, a drug Gosnell used at the clinic to anesthetize patients.

In light of this suspicious death and the other significant health and medical concerns, DEA Agent Stephen Dougherty invited personnel from the Pennsylvania Department of State (which regulates doctors and the practice of medicine) and the Pennsylvania Department of Health (which regulates health care facilities) to accompany law enforcement officers on the February 18 raid. No one from these agencies had visited the clinic in more than 15 years, even after the Department of Health had been informed of Mrs. Mongar’s death months earlier.

The search team waited outside until Gosnell finally arrived at the clinic, at about 8:30 p.m. When the team members entered the clinic, they were appalled, describing it to the Grand Jury as “filthy,” “deplorable,” “disgusting,” “very unsanitary, very outdated, horrendous,” and “by far, the worst” that these experienced investigators had ever encountered.

There was blood on the floor. A stench of urine filled the air. A flea-infested cat was wandering through the facility, and there were cat feces on the stairs. Semi-conscious women scheduled for abortions were moaning in the waiting room or the recovery room, where they sat on dirty recliners covered with blood-stained blankets.

All the women had been sedated by unlicensed staff – long before Gosnell arrived at the clinic – and staff members could not accurately state what medications or dosages they had administered to the waiting patients. Many of the medications in inventory were past their expiration dates.

Investigators found the clinic grossly unsuitable as a surgical facility. The two surgical procedure rooms were filthy and unsanitary – Agent Dougherty described them as resembling “a bad gas station restroom.” Instruments were not sterile. Equipment was rusty and outdated. Oxygen equipment was covered with dust, and had not been inspected. The same corroded suction tubing used for abortions was the only tubing available for oral airways if assistance for breathing was needed. There was no functioning resuscitation or even monitoring equipment, except for a single blood pressure cuff in the recovery room.

Ambulances were summoned to pick up the waiting patients, but (just as on the night Mrs. Mongar died three months earlier), no one, not even Gosnell, knew where the keys were to open the emergency exit. Emergency personnel had to use bolt cutters to remove the lock. They discovered they could not maneuver stretchers through the building’s narrow hallways to reach the patients (just as emergency personnel had been obstructed from reaching Mrs. Mongar).

The search team discovered fetal remains haphazardly stored throughout the clinic – in bags, milk jugs, orange juice cartons, and even in cat-food containers. Some fetal remains were in a refrigerator, others were frozen. Gosnell admitted to Detective Wood that at least 10 to 20 percent of the fetuses were probably older than 24 weeks in gestation – even though Pennsylvania law prohibits abortions after 24 weeks. In some instances, surgical incisions had been made at the base of the fetal skulls.

The investigators found a row of jars containing just the severed feet of fetuses. In the basement, they discovered medical waste piled high. The intact 19-week fetus delivered by Mrs. Mongar three months earlier was in a freezer. In all, the remains of 45 fetuses were recovered at the clinic that evening and turned over to the Philadelphia medical examiner, who confirmed that at least two of them, and probably three, had been viable. 

Read the full grand jury report here.

Abortion industry wages, high and low

Scripture has it that laborers are worthy of their hire. Even abortion workers get paid. But how much?

Jill Stanek, pro-life blogger, activist, and nurse, published a post this evening about a Planned Parenthood affiliate in Pennsylvania. In a column headlined “Slave wages and astronomical insurance premiums,” Stanek reports that Planned Parenthood Keystone (PPKEY) offers its employees working 30 or more hours per week a health insurance plan requiring biweekly payroll deductions of $512.60.

Stanek goes on:

I’m told that PP Keystone workers other than clinic managers and clinicians make only $10-11/hour and are limited to a 35-hour work week. These people include receptionists, medical assistants and “front end and back end staff,” according to my source….How a PP employee making $11/hour, or $1,540 a month, could afford insurance for his or her family is beyond me.

This insurance plan reportedly went into effect November 1, meaning it’s Obamacare-compliant. Maybe PPKEY, like PP of Northern New England, is an Obamacare “navigator” that can help people sign up for subsidized insurance. If so, they already have clients in-house.

The contrast between part-time pay and the cost of health insurance (even under Obamacare) doesn’t shock me. I’m accustomed to seeing figures like that. I’ve had my share of jobs that saw most of my pay going to insurance. Stanek’s post is about more than insurance , though. She contrasts the wages of the lower-paid employees with that of PPKEY’s CEO Kim Custer who, according to Stanek, made $133,165 in 2012. (I have been unable to verify that figure, although I did find that Custer is listed in 2012 annual reports as interim CEO at the Keystone affiliate and full CEO at a larger PP affiliate nearby.)

How does that compare to what goes in in my own back yard? The PPNNE executives’ pay for tax year 2012 is a matter of public record on IRS form 990. Steve Trombley, who has since left the organization, enjoyed base compensation of $243,669 as CEO. Meagan Gallagher’s base salary as Senior Vice-President for Business Operations was $147,069; she has since succeeded Trombley as CEO. The medical director earned $219,616; the vice-president for development settled for $145,017.

That’s three-quarters of a million dollars for four employees, out of $19.6 million in total expenditures for PPNNE in 2012, according to their annual report. There are at least three other employees with six-figure compensation, according to the form 990. One is the highly effective public policy director with whom I cross paths regularly at the State House. It’s a competitive world out there, and the executive salaries reflect that.

(But remember: whenever there’s a cut in government funding to PP, actual or threatened, it’s the cancer screenings that feel the pinch, not the executive salaries. At least, that’s what PPNNE’s representatives told the public after they lost a state family planning contract in 2011. But I digress.)

I don’t know what the rank-and-file workers earn. You know – the ones who have the most contact with clients and patients. How much are the people making who greet patients at the door? How about the intake workers who talk to abortion-minded women? The workers who clean up the “procedure” rooms? The providers who come under contract to do abortions? The security guard I met outside PP in Manchester during 40 Days for Life?

The numbers might be comparable to those in similar industries. The top-to-bottom wage disparity may simply be the free market in action. It would be interesting to know what value a free market assigns to the people standing next to a woman as her child is “terminated.”

 

Lessons from Gosnell: learned, missed, and in progress

Where is New Hampshire, now that the odious Dr. Gosnell awaits sentencing in Pennsylvania? In the dark, mostly. Legislators can change this, although some mighty citizen action might be needed to get the ball rolling. We don’t know how many women choose abortion in New Hampshire. (The Guttmacher/CDC stats are atrocious substitutes for data, relying as they do on voluntary reporting by a limited number of abortion providers.) We don’t know why they choose abortion. We don’t know how many abortions are “early” or “late-term.” We don’t know what the medical protocols are for born-alive babies after attempted abortion. We have no clue whatsoever what is the rate of post-abortion complications for women. We don’t know who’s doing abortions. There is no restriction on who may perform abortion. (None.) We are assured at public hearings that abortion facilities are “licensed,” whatever that means, without being held to the same standards as any other outpatient-surgery facility.

Kermit Gosnell (mug shot following arrest)
Kermit Gosnell (mug shot following arrest)

Ignorance isn’t bliss. It’s negligence on the part of policymakers and public health officials. Time for transparency and serious oversight of the abortion industry. Even a defender of Roe should be able to see that.

Gosnell was operating legally. Don’t overlook that while you’re plowing through the public statements by PP and NARAL since yesterday’s conviction. We can all be appalled about what Gosnell did, and we can all be outraged by the way he and his staff treated women, and we can be outraged by the snipping of born-alive-babies’ necks (although that particular outrage was not expressed universally yesterday). Through it all, remember: he was operating legally, according to the state of Pennsylvania. His butchery was discovered by accident. Despite state policies and abortion regulations, no Pennsylvania official kept Gosnell in line because no Pennsylvania official wanted to look.

What do you want to bet that if Gosnell HAD been inspected, fellow abortion providers would have cried “intimidation!” at the first peep from the inspectors?

And if only Gosnell hadn’t been such a ghoul about keeping babies’ corpses and body parts, he would very likely have escaped prosecution on the premeditated-murder charges.  If the only evidence of the murder of children had been testimony by Gosnell’s staff, his attorneys would have had a field day impeaching those witnesses. The attorneys tried that anyway, even with the sickening physical evidence.

Which brings me to the sobering thought: how many children survive attempted abortion and are born alive? We don’t know. What’s the medical protocol for dealing with “the dreaded complication” of a live birth? It may vary from one facility to another. A law on mandatory statistics, even a law with teeth, may be unable to get at that. The medical profession might have too great a stake in Roe to want those children out in the open. In Gosnell’s case, only when outsiders got a look at the corpses did the story come out. That was an off-chance.

I have already seen in some of the Gosnell coverage that some news outlets refer to the dead babies as “fetuses,” despite the fact that they had emerged from the mothers’ bodies. Three convictions for premeditated murder might not settle the issue. This question comes up again and again as I cover the right to life: does getting an abortion entitle a woman to a terminated pregnancy or a dead baby? No, this is not a matter between “a woman, her family, and her doctor,” as the saying goes – at least I don’t think it is. Will an abortion provider even have to note that a baby was born alive, if the mother is undergoing an abortion? Not unless the “protocols” say so.  After all, if the fetus isn’t “born,” it’s not a person, and homicide laws would not apply. Was that Gosnell’s rationalization for snipping the infants’ spinal cords?

This wouldn’t be the first time Roe made a hash of science. Still think pregnancy begins at conception? Union of sperm and egg? How very seventies of you. Implantation: that’s the ticket. Presto: “emergency contraception” has been declared non-abortive, along with anything else that inhibits implantation. Justice Blackmun would be proud. He was  afraid when he wrote Roe that medical science might declare when life begins, thus undermining the whole “trimester” framework. Not to worry. Medical science has its finger to the political winds.

The “providers” are not likely to come forward about their own acts, if they are “terminating” abortion survivors. It will be left to the witnesses, allied health professionals, to testify to what they see.

Medical protocols will not come to light readily. Ask New Hampshire Right to Life what it takes to get Planned Parenthood of Northern New England to turn over its medical operations manual. (More about that another time.)

Don’t think that serious regulation will come easily. NARAL, PP, and their apologists blame pro-lifers for Gosnell. Seriously. Pennsylvania’s abortion regulations are to blame, they say.

Really?

Did a 24-hour waiting period, required under Pennsylvania law, kill Karnamaya Mongar? No. Kermit Gosnell did. The drug overdose that killed her was not forced on her by any 24-hour wait. “Involuntary manslaughter,” said the jury. Her family is taking civil action against Gosnell. Good luck to them.

Did a ban on abortions post-24-weeks “force” women to Gosnell? No. By the way, Gosnell operated with the knowledge of other abortion providers in the area, including PP of Southeastern Pennsylvania. If anyone from that PP office had concerns about Gosnell doing late-term work, she didn’t advise anyone at the Pennsylvania Department of Health. Hmmm.

Did Pennsylvania’s abortion regulations cause all the carnage? No. There is plenty of blame to go around, but not to the people who fought for the regulations, even if they only exist on paper as abortion providers would prefer. Republican former Governor Tom Ridge discontinued regular inspections of abortion facilities. Workers at Gosnell‘s facility kept quiet for years. Medical providers who found themselves taking care of women harmed at the Gosnell facility did not make enough of a fuss for health authorities to take notice.

Gosnell’s crimes did not consist principally in the filth of his office. If he had kept a clean place, the snipped babies would still be dead. We’d just be less likely to know about them. A tidy facility wouldn’t have helped Karnamaya Mongar survive a drug overdose. Declaring Gosnell an outlier, as abortion advocates have done, means nothing if it is only an admonition to maintain good housekeeping.

So much room for improvement, for the women, for their children. Until New Hampshire moves past housekeeping concerns and deals with abortion itself, Gosnell has taught us nothing.