Butcher of Women in Philly Arrested.

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Butcher of Women in Philly Arrested.

Post by MKSheppard »

Philly CBS affiliate Story

But if you want the primary source material; read the philly grand jury report: link to PDF.

The title of the thread is from a subheader in that Grand Jury Report.

Here's some snippets of the GJ report:
With abortion, as with prescriptions, Gosnell’s approach was simple: keep volume high, expenses low – and break the law. That was his competitive edge.

Pennsylvania, like other states, permits legal abortion within a regulatory framework. Physicians must, for example, provide counseling about the nature of the procedure. Minors must have parental or judicial consent. All women must wait 24 hours after first visiting the facility, in order to fully consider their decision. But Gosnell’s compliance with such requirements was casual at best. At the Women’s Medical Society, the only question that really mattered was whether you had the cash.

Too young? No problem. Didn’t want to wait? Gosnell provided same-day service.

The real key to the business model, though, was this: Gosnell catered to the women who couldn’t get abortions elsewhere – because they were too pregnant. Most doctors won’t perform late second-trimester abortions, from approximately the 20th week of pregnancy, because of the risks involved. And late-term abortions after the 24th week of pregnancy are flatly illegal. But for Dr. Gosnell, they were an opportunity. The bigger the baby, the more he charged.

There was one small problem. The law requires a measurement of gestational age, usually done by an ultrasound. The ultrasound film would leave documentary proof that the abortion was illegal. Gosnell’s solution was simply to fudge the measurement process. Instead of hiring proper ultrasound technicians, he “trained” the staff himself, showing them how to aim the ultrasound probe at an angle to make the fetus look smaller. If one of his workers nonetheless recorded an ultrasound measurement that was too big, it would just be redone. Invariably these second ultrasounds would come in lower. In fact, almost every time a second ultrasound was taken, the gestational age would be recorded as precisely 24.5 weeks – slightly past the statutory cutoff. Apparently Gosnell thought he would get away with abortions that were just a little illegal. In reality, of course, most of these pregnancies were considerably more advanced.

....

There remained, however, a final difficulty. When you perform late-term “abortions” by inducing labor, you get babies. Live, breathing, squirming babies. By 24 weeks, most babies born prematurely will survive if they receive appropriate medical care. But that was not what the Women’s Medical Society was about. Gosnell had a simple solution for the unwanted babies he delivered: he killed them. He didn’t call it that. He called it “ensuring fetal demise.” The way he ensured fetal demise was by sticking scissors into the back of the baby’s neck and cutting the spinal cord. He called that “snipping.”

...

Most of these acts cannot be prosecuted, because Gosnell destroyed the files.

Among the relatively few cases that could be specifically documented, one was Baby Boy A. His 17-year-old mother was almost 30 weeks pregnant – seven and a half months – when labor was induced. An employee estimated his birth weight as approaching six pounds. He was breathing and moving when Dr. Gosnell severed his spine and put the body in a plastic shoebox for disposal. The doctor joked that this baby was so big he could “walk me to the bus stop.”

Another, Baby Boy B, whose body was found at the clinic frozen in a one-gallon spring-water bottle, was at least 28 weeks of gestational age when he was killed. Baby C was moving and breathing for 20 minutes before an assistant came in and cut the spinal cord, just the way she had seen Gosnell do it so many times.

......

Butcher of women

Dr. Gosnell didn’t just kill babies. He was also a deadly threat to mothers. Not every abortion could be completed by inducing labor and delivery. On these occasions, Gosnell would attempt to remove the fetus himself.

The consequences were often calamitous – though that didn’t stop the doctor from trying to cover them up.

One woman, for example, was left lying in place for hours after Gosnell tore her cervix and colon while trying, unsuccessfully, to extract the fetus. Relatives who came to pick her up were refused entry into the building; they had to threaten to call the police.

They eventually found her inside, bleeding and incoherent, and transported her to the hospital, where doctors had to remove almost half a foot of her intestines.

On another occasion, Gosnell simply sent a patient home, after keeping her mother waiting for hours, without telling either of them that she still had fetal parts inside her. Gosnell insisted she was fine, even after signs of serious infection set in over the next several days. By the time her mother got her to the emergency room, she was unconscious and near death.

A nineteen-year-old girl was held for several hours after Gosnell punctured her uterus. As a result of the delay, she fell into shock from blood loss, and had to undergo a hysterectomy.

One patient went into convulsions during an abortion, fell off the procedure table, and hit her head on the floor. Gosnell wouldn’t call an ambulance, and wouldn’t let the woman’s companion leave the building so that he could call an ambulance.

...


Only in one class of cases did Gosnell exercise any real care with these dangerous sedatives. On those rare occasions when the patient was a white woman from the suburbs, Gosnell insisted that he be consulted at every step. When an employee asked him why, he said it was “the way of the world.”

Karnamaya Mongar was not one of the privileged patients. She was a 41-year old, refugee who had recently come to the United States from a resettlement camp in Nepal. When she arrived at the clinic, Gosnell, as usual, was not there. Office workers had her sign various forms that she could not read, and then began doping her up. She received repeated unmonitored, unrecorded intravenous injections of Demerol, a sedative seldom used in recent years because of its dangers. Gosnell liked it because it was cheap.

After several hours, Mrs. Mongar simply stopped breathing. When employees finally noticed, Gosnell was called in and briefly attempted to give CPR. He couldn’t use the defibrillator (it was broken); nor did he administer emergency medications that might have restarted her heart. After further crucial delay, paramedics finally arrived, but Mrs. Mongar was probably brain dead before they were even called. In the meantime, the clinic staff hooked up machinery and rearranged her body to make it look like they had been in the midst of a routine, safe abortion procedure.

Even then, there might have been some slim hope of reviving Mrs. Mongar. The paramedics were able to generate a weak pulse. But, because of the cluttered hallways and the padlocked emergency door, it took them over twenty minutes just to find a way to get her out of the building. Doctors at the hospital managed to keep her heart beating, but they never knew what they were trying to treat, because Gosnell and his staff lied about how much anesthesia they had given, and who had given it. By that point, there was no way to restore any neurological activity. Life support was removed the next day. Karnamaya Mongar was pronounced dead.

...

Pennsylvania is not a third-world country. There were several oversight agencies that stumbled upon and should have shut down Kermit Gosnell long ago. But none of them did, not even after Karnamaya Mongar’s death. In the end, Gosnell was only caught by accident, when police raided his offices to seize evidence of his illegal prescription selling. Once law enforcement agents went in, they couldn’t help noticing the disgusting conditions, the dazed patients, the discarded fetuses.
The guy's like some evil twin of Shroom in which all the jokes are...true. :wtf:

Oh, and apparently from 1993> onwards, Pennsylvania stopped actively inspecting abortion clinics under the rationale that inspections would form a barrier to women seeking abortion.
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Re: Butcher of Women in Philly Arrested.

Post by General Zod »

Well . . . that was certainly enough to make me somewhat nauseous. Can someone who managed to read the full thing sum up whether or not this waste of genetic material was sentenced?
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Re: Butcher of Women in Philly Arrested.

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I'm curious if they'll seek the death penalty on this one. This case is going to be a nightmare as they're going to have to define the fetal children as children rather that fetuses in order to pursue it which brings up a whole slew of constitutional arguments and abortion issues. But endangering a patient and committing criminal malpractice don't seem sufficient to me considering what he did.
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Re: Butcher of Women in Philly Arrested.

Post by Broomstick »

Todeswind wrote:I'm curious if they'll seek the death penalty on this one. This case is going to be a nightmare as they're going to have to define the fetal children as children rather that fetuses in order to pursue it which brings up a whole slew of constitutional arguments and abortion issues.
Uh.... a "fetus" born after 7 months gestation is considered a baby, particularly when born alive as in one of the instances mentioned in the article. Past 24 weeks (as mentioned in the article if you go that far) it's almost impossible to get an abortion anywhere in the US unless you're in imminent danger of death - at that point it's called "early delivery" or "premature birth".

That, and he also killed several women via malpractice, so they could get him on killing the adults even if they didn't bring up the children.
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Re: Butcher of Women in Philly Arrested.

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Well yes of course. I'm mostly concerned about what charges are brought about the specific charges filed against the children, the parents are obviously more cut and dry cases.
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Re: Butcher of Women in Philly Arrested.

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Why wouldn't the babies be cut and dry cases? They were born, breathing and alive, and then had their spinal cords cut...apart...with...scissors...

Fuck. I find it hard to even write about it. Anyway, the babies would've survived given proper medical care, so it seems clear it would be murder. Anyway, it'll be hard to find a jury that won't convict him in an emotional case like that.

I mean, the police found discarded fetuses on the premises. The prosecutor is going to have it easy.
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Re: Butcher of Women in Philly Arrested.

Post by loomer »

Todeswind wrote:I'm curious if they'll seek the death penalty on this one. This case is going to be a nightmare as they're going to have to define the fetal children as children rather that fetuses in order to pursue it which brings up a whole slew of constitutional arguments and abortion issues. But endangering a patient and committing criminal malpractice don't seem sufficient to me considering what he did.
I'm pretty sure once the child is actually born via induced labour and then has it's spinal cord severed, it's not really an abortion and more of a murder, as PeZook says. Even with partial birth abortions, they aren't actually born alive.
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Re: Butcher of Women in Philly Arrested.

Post by That NOS Guy »

Cynically speaking, I'd expect this kind of bullshit to go down in the really bad areas of Philadelphia given Police attentions there, but how this dude was operating in freakin' University City and wasn't caught somewhat immediately is boggling.
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Re: Butcher of Women in Philly Arrested.

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loomer wrote:I'm pretty sure once the child is actually born via induced labour and then has it's spinal cord severed, it's not really an abortion and more of a murder, as PeZook says. Even with partial birth abortions, they aren't actually born alive.
And if they DO survive a late term abortion, then as soon as it's known they're alive and breathing resuscitation efforts must be done and they are from that point treated as a person. A late term abortion is, essentially, either inducing labor or performing a cesarean.
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Re: Butcher of Women in Philly Arrested.

Post by PeZook »

Even if there's a medical condition that makes an "abortion" like that necessary, the doctors won't fucking snip the spinal cord with scissors. The now-baby will be rushed to the ICU in an attempt to save it.
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Re: Butcher of Women in Philly Arrested.

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loomer wrote: I'm pretty sure once the child is actually born via induced labour and then has it's spinal cord severed, it's not really an abortion and more of a murder, as PeZook says. Even with partial birth abortions, they aren't actually born alive.
It's a matter of semantic definition that I have no doubt his lawyer will milk for all it's worth. Abortion law is almost wholly defined by semantic definition, and the interpretations of the difference between a early human zygote, a fetus, and a late term fetus are by no means finite with relation to when life "begins." That being said I suspect that the people who would define the fetuses in question as anything other than living humans other than the defendant and his lawyer are probably in the stark minority. The subject will invariably come up.

On a more personal note the more I hear about this the more appealing I find the death penalty to be. I would gladly "flip the switch" on this man myself with a smile on my face and a song on my lips. He a deplorable, utterly revoltingly, vile example of the worst sort of medical hackery I can remember as of late.
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Re: Butcher of Women in Philly Arrested.

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It's strange that he and that staffer of his could even bring himself to do that. Generally speaking humans are powerfully wired against hurting infants. There's physiological reactions to sounds similar to a crying baby, and we even find animals with general characteristics of human babies cute. The idea of calmly stabbing scissors into the neck of a crying baby is...revolting on a primordial level, somehow. Far more than abandoning infants to die of exposure, even if it's technically less cruel.
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Re: Butcher of Women in Philly Arrested.

Post by Simon_Jester »

Todeswind wrote:
loomer wrote: I'm pretty sure once the child is actually born via induced labour and then has it's spinal cord severed, it's not really an abortion and more of a murder, as PeZook says. Even with partial birth abortions, they aren't actually born alive.
It's a matter of semantic definition that I have no doubt his lawyer will milk for all it's worth. Abortion law is almost wholly defined by semantic definition, and the interpretations of the difference between a early human zygote, a fetus, and a late term fetus are by no means finite with relation to when life "begins." That being said I suspect that the people who would define the fetuses in question as anything other than living humans other than the defendant and his lawyer are probably in the stark minority. The subject will invariably come up.
I am honestly dubious of the argument that the lawyer will do this. For one it won't work well on any probable jury (since said jury will contain people who already think that even a four-week embryo is human. For another the argument doesn't give the defender a leg to stand on, because it contradicts the existing legislation and precedents. It's like trying to argue that your client isn't a thief because of some nitpick with the definition of 'theft'... when no such flaw in the definition exists and you're making the whole thing up.

Not gonna help.
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Re: Butcher of Women in Philly Arrested.

Post by Enigma »

I searched Google and he's being charged with 8 counts of murder, 7 for the deaths of babies and 1 for that Nepalese woman.
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Re: Butcher of Women in Philly Arrested.

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From the National Abortion and Reproductive Rights Action League (NARAL) website on late-term Pennsylvania abortion law:
Pennsylvania's post-viability abortion restriction states that no abortion may be provided after the 23rd week of pregnancy unless the attending physician and another physician who has examined the woman concur in writing that the procedure is necessary to preserve the woman's life or to prevent a "substantial and irreversible impairment of a major bodily function." The physician must use the procedure most likely to result in fetal survival unless in the physician's good faith medical judgment that method poses a significantly greater risk of the woman's death or a "substantial and irreversible impairment of a major bodily function" of the woman than other available methods. A second physician must attend. 18 Pa. Cons. Stat. Ann. § 3211 (Enacted 198
Obviously, the doctor in the OP was in violation of this, as well as other laws. Clearly, the intent of this law is that whenever possible after 23 weeks an abortion only in dire circumstance and even then there must be a realistic effort to save the fetus/child if that is at all possible.
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Re: Butcher of Women in Philly Arrested.

Post by MKSheppard »

Enigma wrote:I searched Google and he's being charged with 8 counts of murder, 7 for the deaths of babies and 1 for that Nepalese woman.
Better. Read the GJ report:
  • We recommend that Kermit Gosnell, Lynda Williams, and Sherry West be charged with third-degree murder, pursuant to 18 Pa.C.S. § 2502(c). (Karnamaya Mongar)
  • We recommend prosecuting Kermit Gosnell, Lynda Williams, and Sherry West for Drug Delivery Resulting in Death (Karnamaya Mongar)
  • We recommend that Kermit Gosnell be charged with murder for killing Baby Boy A.
  • We recommend a murder charge against Kermit Gosnell in the death of Baby Boy B.
  • We recommend murder and conspiracy charges against Kermit Gosnell and Lynda Williams for the murder committed by Lynda Williams in 2006 or 2007 of "Baby C."
  • There is sufficient evidence to charge Adrienne Moton and Kermit Gosnell with murder and conspiracy in the death of “Baby D.”
  • We recommend charging Kermit Gosnell with Criminal Solicitation of Adrienne Moton.
  • We recommend that a murder charge be filed against Kermit Gosnell for the murder of “Baby E"
  • We recommend murder and conspiracy charges against Kermit Gosnell and Steven Massof for killing “Baby F.”
  • The evidence supports charges of murder and conspiracy against Kermit Gosnell and Steven Massof for the killing of Baby G.
  • The evidence warrants three charges of criminal solicitation against Kermit Gosnell.
  • In addition to the specific murder charges identified above, we recommend that Kermit Gosnell, Lynda Williams, Sherry West, Adrienne Moton, and Steven Massof be charged with conspiracy to commit murder.
But wait! There's more!
  • We recommend that Kermit Gosnell be charged with two counts of infanticide
  • We recommend that Kermit Gosnell, Lynda Williams, and Sherry West be charged with felony drug offense under the Controlled Substances Act.
  • We recommend that Kermit Gosnell, Lynda Williams, and Sherry West be charged with conspiracy (Drug Offense)
  • And because Gosnell instructed Williams and West to drug Mrs. Mongar, we recommend that Kermit Gosnell be charged with two counts of criminal solicitation.
  • We recommend that Kermit Gosnell be charged with the crime of hindering. (From when he prevented women from getting medical attention)
  • Because West also actively sought to minimize Williams’s and Gosnell’s culpability for Mrs. Mongar’s death by providing false or misleading information, we recommend that Sherry West be charged with tampering with or fabricating physical evidence, tampering with records, and hindering apprehension or prosecution.
  • We recommend charging Liz Hampton with perjury in light of her patently false testimony to the Grand Jury about events surrounding the death of Mrs. Mongar.
Still even more!
  • We recommend that Kermit Gosnell be charged with 33 counts of performing illegal abortions
  • We recommend that Lynda Williams and Sherry West be charged with performing illegal late-term abortions, and that Kermit Gosnell, Williams, and West be charged with conspiracy to perform abortions beyond 24 weeks.
  • We recommend prosecuting Pearl Gosnell for performing, and conspiring with her husband to perform, illegal abortions, based on testimony that she assisted him on Sundays.
  • We recommend that Kermit Gosnell be charged with 310 counts of violating the Abortion Control Act. (Due to him performing abortions on the same day, instead of waiting 24 hrs)
  • Based the evidence, we recommend that Gosnell be charged with five counts of abuse of corpse. (Babies in jars)
  • We recommend that Kermit Gosnell, Eileen O’Neill, and Steven Massof be charged with theft by deception and conspiracy to commit theft by deception. (He hired two med school grads -- Steven Massof and Elieen O'Neill who passed themselves off as doctors to patients).
  • We recommend charging Eileen O’Neill with false swearing and perjury. (She swore under oath that she did not treat patients at the clinic).
  • We recommend that Kermit Gosnell and Steven Massof be charged with conspiring to violate the Controlled Substances Act.
Don't worry. We're finally getting to the end. Honest!
  • We recommend charging Kermit Gosnell, Lynda Williams, Sherry West, Eileen O’Neill, Steven Massof, and Tina Baldwin with violating the corrupt organization statute, 18 Pa.C.S. § 911, based on a pattern of racketeering activity. We recommend that these same six individuals as well as Pearl Gosnell and Maddline Joe be charged with conspiring to commit racketeering activity.
  • We recommend that charges of conspiracy to violate the corrupt organizations statute be brought against Kermit Gosnell, Pearl Gosnell, Lynda Williams, Sherry West, Adrienne Moton, Steven Massof, Eileen O’Neill, Tina Baldwin, and Maddline Joe.
I'll let the DA explain it:

Gosnell ran a corrupt organization. He performed illegal late-term abortions that resulted in babies born alive, whom he killed, or had others kill; he directed his workers to sedate patients with narcotics in violation of the controlled substances act; and he employed bogus doctors to treat unsuspecting, paying patients. Maddline Joe, his office administrator, collected the money that came in from these criminal activities. Williams, West, O’Neill, Massof, Tina Baldwin, and Pearl Gosnell all actively participated in various aspects of Gosnell’s corrupt organization.
  • We recommend that Kermit Gosnell be charged with obstruction and tampering.
DA once again:

Between the time that law enforcement officials raided Gosnell’s office in February 2010 and the time that investigators returned with a warrant to seize patient files, many files disappeared. We viewed a videotape of the raid and saw files on shelves outside the procedure rooms. Latosha Lewis and others told us that these were recent second-trimester abortion files. The shelves were bare when investigators returned.

Finally, the ultimate garnish on top of this horrible layered cake of horribility:
  • We recommend charging Kermit Gosnell with corruption of a minor. We also recommend that Tina Baldwin be charged with the same crime.
Once again the DA:

Gosnell hired high school student Ashley Baldwin to medicate patients, in violation of the Controlled Substances Act, and to assist with illegal abortions, in violation of the Abortion Control Act. Ashley’s mother had worked at the clinic for years, assisting Gosnell with abortions, including illegal late-term abortions, and with medicating patients, in violation of the Controlled Substances Act

Ashley was only 15 when she began working for Gosnell. He subsequently trained her, as he had trained her mother, to assist with abortions and give medications to patients.

Tina Baldwin and Ashley Baldwin both testified that Gosnell would keep Ashley at the clinic, assisting with abortions, sometimes until well after midnight, even though Ashley was still in high school. Tina Baldwin knew her daughter was being directed to perform tasks that she was not authorized to do

...

Tina worked for Gosnell for several years before recommending her daughter for employment.

As Ashley’s involvement in Gosnell’s illegal practices became deeper – at one point she was working 50-hour weeks and well past midnight, while trying to complete high school – Tina did nothing to curtail her minor daughter’s exploitation by Gosnell.

..

We also reviewed evidence that Gosnell did not obtain parental consent, as required under the Abortion Control Act, before performing abortions on minors. The law bars such patients from obtaining abortions without parental consent or judicial approval, but Gosnell went ahead and performed the abortions.

Based on two files from the past two years, in which we found there was no parental signature, we recommend two additional charges against Kermit Gosnell for corruption of a minor.


Wow.

This is a very unusually blunt Grand Jury filing for a district attorney. At times it takes such a strong tone, that you have to check it every so often to see that it's coming from the Philly District Attorney's office and not from a pro life organization.
The first line of defense was the Pennsylvania Department of Health. The department’s job is to audit hospitals and outpatient medical facilities, like Gosnell’s, to make sure that they follow the rules and provide safe care. The department had contact with the Women’s Medical Society dating back to 1979, when it first issued approval to open an abortion clinic. It did not conduct another site review until 1989, ten years later.

Numerous violations were already apparent, but Gosnell got a pass when he promised to fix them. Site reviews in 1992 and 1993 also noted various violations, but again failed to ensure they were corrected.

But at least the department had been doing something up to that point, however ineffectual.

After 1993, even that pro forma effort came to an end. Not because of administrative ennui, although there had been plenty.

Instead, the Pennsylvania Department of Health abruptly decided, for political reasons, to stop inspecting abortion clinics at all.

The politics in question were not anti-abortion, but pro. With the change of administration from Governor Casey to Governor Ridge, officials concluded that inspections would be “putting a barrier up to women” seeking abortions.

Better to leave clinics to do as they pleased, even though, as Gosnell proved, that meant both women and babies would pay.

The only exception to this live-and-let-die policy was supposed to be for complaints dumped directly on the department’s doorstep.

Those, at least, would be investigated.

Except that there were complaints about Gosnell, repeatedly. Several different attorneys, representing women injured by Gosnell, contacted the department. A doctor from Children’s Hospital of Philadelphia hand-delivered a complaint, advising the department that numerous patients he had referred for abortions came back from Gosnell with the same venereal disease. The medical examiner of Delaware County informed the department that Gosnell had performed an illegal abortion on a 14-year-old girl carrying a 30-week-old baby. And the department received official notice that a woman named Karnamaya Mongar had died at Gosnell’s hands.

Yet not one of these alarm bells – not even Mrs. Mongar’s death – prompted the department to look at Gosnell or the Women’s Medical Society.

Only after the raid occurred, and the story hit the press, did the department choose to act.

Suddenly there were no administrative, legal, or policy barriers; within weeks an order was issued to close the clinic.

And as this grand jury investigation widened, department officials “lawyered up,” hiring a high-priced law firm to represent them at taxpayer expense.

Had they spent as much effort on inspection as they did on attorneys, none of this would have happened to begin with.

But even this total abdication by the Department of Health might not have been fatal.

Another agency with authority in the health field, the Pennsylvania Department of State, could have stopped Gosnell single-handedly.

While the Department of Health regulates facilities, the Department of State, through its Board of Medicine, licenses and oversees individual physicians. Like their colleagues at Health, however, Department of State officials were repeatedly confronted with evidence about Gosnell, and repeatedly chose to do nothing.

Indeed, in many ways State had more damning information than anyone else.

Almost a decade ago, a former employee of Gosnell presented the Board of Medicine with a complaint that laid out the whole scope of his operation: the unclean, unsterile conditions; the unlicensed workers; the unsupervised sedation; the underage abortion patients; even the over-prescribing of pain pills with high resale value on the street.

The department assigned an investigator, whose investigation consisted primarily of an offsite interview with Gosnell.

The investigator never inspected the facility, questioned other employees, or reviewed any records. Department attorneys chose to accept this incomplete investigation, and dismissed the complaint as unconfirmed.

Shortly thereafter the department received an even more disturbing report – about a woman, years before Karnamaya Mongar, who died of sepsis after Gosnell perforated her uterus. The woman was 22 years old. A civil suit against Gosnell was settled for almost a million dollars, and the insurance company forwarded the information to the department.

That report should have been all the confirmation needed for the complaint from the former employee that was already in the department’s possession. Instead, the department attorneys dismissed this complaint too. They concluded that death was just an “inherent” risk, not something that should jeopardize a doctor’s medical license.

The same thing happened at least twice more: the department received complaints about lawsuits against Gosnell, but dismissed them as meaningless. A department attorney said there was no “pattern of conduct.” He never bothered to check a national litigation database, which would have shown that Gosnell had paid out damages to at least five different women whose internal organs he had punctured during abortions.

Apparently, the missing piece in the “pattern” was press coverage. Once that began, after the raid, the department attorney quickly managed to secure a license suspension against Gosnell.

Similar inaction occurred at the municipal level. The Philadelphia Department of Public Health does not regulate doctors or medical facilities; but it is supposed to protect the public’s health.

Philadelphia health department employees regularly visited the Women’s Medical Society to retrieve blood samples for testing purposes, but never noticed, or more likely never bothered to report, that anything was amiss.

Another employee inspected the clinic in response to a complaint that dead fetuses were being stored in paper bags in the employees’ lunch refrigerator. The inspection confirmed numerous violations of protocols for storage and disposal of infectious waste. But no follow-up was ever done, and the violations continued to the end.

A health department representative also came to the clinic as part of a citywide vaccination program.

She promptly discovered that Gosnell was scamming the program; more importantly, she was the only employee, city or state, who actually tried to do something about the appalling things she saw there. By asking questions and poking around, she was able to file detailed reports identifying many of the most egregious elements of Gosnell’s practice.

It should have been enough to stop him. But instead her reports went into a black hole, weeks before Karnamaya Mongar walked into the Woman’s Medical Society.

Ironically, the doctor at CHOP who personally complained to the Pennsylvania Department of Health about the spread of venereal disease from Gosnell’s clinic, the doctor who used to refer teenage girls to Gosnell for abortions, became the head of the city’s health department two years ago.

But nothing changed in the time leading up to Mrs. Mongar’s death. And it wasn’t just government agencies that did nothing.

The Hospital of the University of Pennsylvania and its subsidiary, Penn Presbyterian Medical Center, are in the same neighborhood as Gosnell’s office. State law requires hospitals to report complications from abortions. A decade ago, a Gosnell patient died at HUP after a botched abortion, and the hospital apparently filed the necessary report.

But the victims kept coming in. At least three other Gosnell patients were brought to Penn facilities for emergency surgery; emergency room personnel said they have treated many others as well. And at least one additional woman was hospitalized there after Gosnell had begun a flagrantly illegal abortion of a 29-week-old fetus.

Yet, other than the one initial report, Penn could find not a single case in which it complied with its legal duty to alert authorities to the danger. Not even when a second woman turned up virtually dead.

So too with the National Abortion Federation. NAF is an association of abortion providers that upholds the strictest health and legal standards for its members.

Gosnell, bizarrely, applied for admission shortly after Karnamaya Mongar’s death. Despite his various efforts to fool her, the evaluator from NAF readily noted that records were not properly kept, that risks were not explained, that patients were not monitored, that equipment was not available, that anesthesia was misused. It was the worst abortion clinic she had ever inspected.

Of course, she rejected Gosnell’s application. She just never told anyone in authority about all the horrible, dangerous things she had seen.

Bureaucratic inertia is not exactly news. We understand that. But we think this was something more. We think the reason no one acted is because the women in question were poor and of color, because the victims were infants without identities, and because the subject was the political football of abortion.
The GJ report continues in it's organ grinding, you would think that this is a script from Law and Order and that McCoy is fuliminating before a judge:
As a final note, we charge Gosnell and Tina Baldwin, his employee, with corrupting the morals of a minor.

Gosnell hired Tina’s 15-year-old daughter as a staff member. She was required to work 50-hour weeks, starting after school until past midnight, during which she was exposed to the full horrors of Gosnell’s practice. Bad enough that he expected grown-ups to do it.

That leaves the government employees whose job was to make sure that things like this don’t happen.

Worth special mention is Janice Staloski of the Pennsylvania Department of Health, who personally participated in the 1992 site visit, but decided to let Gosnell slide on the violations that were already evident then. She eventually rose to become director of the division that was supposed to regulate abortion providers, but never looked at Gosnell despite specific complaints from lawyers, a doctor, and a medical examiner.

After she was nonetheless promoted, her successor as division director, Cynthia Boyne, failed to order an investigation of the clinic even when Karnamaya Mongar died there.

Senior legal counsel Kenneth Brody insisted that the department had no legal obligation to monitor abortion clinics, even though it exercised such a duty until the Ridge administration, and exercised it again as soon as Gosnell became big news.

The agency’s head lawyer, chief counsel Christine Dutton, defended the department’s indifference: “People die,” she said.

Lawyers at the Pennsylvania Department of State behaved in the same fashion.

Attorneys Mark Greenwald, Charles Hartwell, David Grubb, Andrew Kramer, William Newport, Juan Ruiz, and Kerry Maloney were confronted with a growing pile of disquieting facts about Gosnell, including a detailed, inside account from a former employee, and a 22-year-old dead woman.

Every time, though, they managed to dismiss the evidence as immaterial. Every time, that is, until the facts hit the fan.

We want better from our public servants. We trust that their actions will be reviewed, and that they will be held accountable.
The recommendations that the GJ put forth were pretty strong too; I'll try to summarize some of them:

There should be no statute of limitations for infanticide

We are disappointed that we can charge him for only the babies he let die in the past two years. Homicide has no statute of limitations, and neither should infanticide.

The statute of limitations for illegal abortions beyond 24 weeks should be extended to five years.

Again, the jurors were frustrated that we could not recommend charges against Gosnell for scores of crimes we know he committed. We recommend that the statute of limitations for illegal post-24-week abortions be extended to five years.

Impersonating a doctor should be a crime

We were surprised to find out that impersonating a doctor in Pennsylvania is not a crime. There are civil sanctions for those who practice medicine without a license, but not criminal sanctions. Pretending to be a doctor is a serious offense.

The Abortion Control Act should be amended to prohibit the mutilation of fetal remains.

One of the most bizarre things about this case is Dr. Gosnell’s fetal foot collection. He cut the feet off the fetuses he aborted and kept them in a row of jars. No civilized society can accept such an abomination, whether the fetuses in question were viable or not.

The Pennsylvania Department of Health should license abortion clinics as ambulatory surgical facilities.

Under the plain language of the Health Care Facilities Act, abortion clinics should be regulated, licensed, and monitored as Ambulatory Surgical Facilities.

Had the state Department of Health not inexplicably declined to classify abortion clinics as ASFs, Gosnell’s clinic would have been subject to yearly inspection and licensing.

The department’s inspectors could have inspected at any time, announced or unannounced, to investigate any complaints. The sight of unlicensed employees sedating patients in Gosnell’s absence would presumably have triggered action. Given the clinic’s filthy conditions, it surely would have been shut down long ago if DOH had merely taken a look.

The regulations for 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.

The state Department of Health should update the regulations for abortion providers.

Officials from the Pennsylvania Department of Health complained that the regulations that it wrote do not give it the authority needed to carry out its duty to protect the health of women having abortions and of premature babies delivered alive.

(Huge list of recommendations for regulatory changes including a huge load of requirements that abortion facilities would have to follow.)

Pennsylvania’s Departments of Health and State should make their process for filing complaints against doctors and facilities simpler and more responsive.

The Pennsylvania Department of Health makes it next to impossible to file a complaint concerning abortion providers.

We could find no mention on its website that the department was even responsible for regulating or overseeing abortion clinics.

When persistent lawyers, like Semika Shaw’s; and doctors, such as Dr. Hellman, the Medical Examiner from Delaware County, and Dr. Schwarz, Philadelphia’s Health Commissioner, have registered complaints anyway, they have been uniformly ignored.

DOH did not inspect Gosnell’s clinic even after Karnamaya Mongar died.

We applaud the current Secretary of Health for reinstituting regular inspections of abortion facilities.

But the department must also develop an effective, easy, and responsive complaint process.

Philadelphia’s Department of Public Health should develop a hotline to assist residents in filing complaints with the proper state and local authorities

The Pennsylvania Departments of Health and State need to share information they receive that is pertinent to each other’s responsibilities

The Department of State should train its prosecutors and provide the necessary tools so they can more effectively investigate complaints against doctors.

Our review of the Department of State’s handling of complaints filed against Gosnell revealed many problems.

Some of the prosecutors seemed to be unaware of the full history of complaints against the doctor.

Others seemed not to coordinate with a colleague who was working on a similar complaint. Prosecutor Ruiz said that he had no way to find out about malpractice suits filed against a doctor, unless they were reported to the department. And some Board of Medicine attorneys simply used terrible judgment – closing an “investigation” of a death with no apparent investigation.

The Pennsylvania Departments of Health and State should be required to share with law enforcement information relevant to criminal investigations

The jurors are aware that the Department of State initially asserted some type of privilege with respect to the confidentiality of its investigative files.

We also heard evidence that Department of Health investigators were instructed by department lawyers not to share information about Karnamaya Mongar’s death with law enforcement.

And, in fact, DOH did not share with law enforcement the letter that Gosnell sent to the department notifying it of Mrs. Mongar’s death.

That letter, in which Gosnell admitted what drugs were administered, but lied about how much medication was given and by whom, would have been helpful to have before the February 2010 raid.

A task force including the Medical Examiner’s Office, the District Attorney’s Office, and the Police Department should work to improve protocols for investigating suspicious deaths.

We are troubled that Mrs. Mongar’s death might have gone unnoticed if not for the drug raid three months later. The city must improve protocols for investigating suspicious deaths that require investigation before they can be labeled homicide.

The City of Philadelphia should enforce medical waste disposal plans that it requires from providers.

We recommend that the National Abortion Federation reconsider the inclusion of Atlantic Women’s Medical Services in Delaware in its membership.

We recommend that NAF reassess the membership of Atlantic Women’s Medical Services, the Delaware abortion clinic where Gosnell worked part-time before losing his license in that state.

We learned that at least six patients were referred from Atlantic to Gosnell’s clinic in Philadelphia for illegal late-term abortions.

These patients paid Atlantic for late-term procedures performed by Gosnell in his Lancaster Avenue clinic.

We heard evidence that Gosnell would insert laminaria in patients in Delaware and then have them come to his Philadelphia office for the abortion procedure itself.

The authorities responsible for overseeing, monitoring, or licensing Gosnell or his operation should conduct serious self-assessments to determine why their departments failed to protect the women and babies whose lives were imperiled at Gosnell’s clinic. Employees who failed to perform their jobs of protecting the public should be held accountable.

It is not our job to say who should be fired or demoted. We believe, however, that anyone responsible for permitting Gosnell to operate as he did should face strong disciplinary action up to and including termination.

This includes not only the people who failed to do the inspecting, the prosecuting, and the protecting, but also those at the top who obviously tolerated, or even encouraged, the inaction.

--------------------------------------------------------

The recommendation that the Penn DoH classify abortion clinics as ASFs is going to be the most controversial -- a bill was proposed down in Florida a while back to do something like that; hold clinics to the same standards as other outpatient facilities in the State. It got shot down in a firestorm for the same reason that Penn DoH refused to inspect clinics from 1993-2010 -- it would impose a barrier on women seeking abortion.
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Re: Butcher of Women in Philly Arrested.

Post by Simon_Jester »

Gosnell would have been just as much of a hack doing any other kind of medical procedure (as demonstrated by his drug prescriptions) as he was with abortions. I think if you're going to apply inspection standards to abortion clinics, the standards need to be tailored to what the clinics do and do not do. Laser-vision surgery facilities would logically be subject to similar but not entirely identical standards as facilities that perform liposuction, and both would be different from an abortion clinic.

The one thing I think any rational person can agree on is that there should not be no standards whatsoever, which is basically the regulatory regime that Gosnell operated in: he was in a total enforcement vacuum.

The problem is to craft regulations that do not amount to a way of banning abortion on the sly; it should be very easy to do this assuming good faith on the part of the regulators.

On the other hand, one has to wonder... how many abortions were performed in the 'illegal nearly everywhere' regime that applied pre-Roe v. Wade? How many of them were performed under conditions like this, simply because anyone performing an abortion was already committing a crime and had little reason to fear the risk of additional punishment for violating other medical regulations?
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Re: Butcher of Women in Philly Arrested.

Post by Eternal_Freedom »

^That is a number I do not wish to know. I find it quite astonishing that he was able to keep this going for all these years. I know law enforcement and medical standards people make mistakes and overlook things accidentally, but this reads like a worst-case scenario of what could happen if an inspector or whatever misses something.

I really hope they go for the death penalty on this one. Even though I don't normally like capital punishment in this case I would not object. I almost wish I was still a Christian so I could pray for him to wind up in the depths of Hell.
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Re: Butcher of Women in Philly Arrested.

Post by White Haven »

I question not the charges laid against him (good, burn) or the regulatory environment, but rather when we'll start to see criminal charges and mass firings at the various and sundry health organizations who failed utterly. Once I got past the visceral horror of the actions themselves, that's what truly struck me as sick about all this; not one man, but the dozens and dozens who aided and abetted him from within and without the clinic.
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Re: Butcher of Women in Philly Arrested.

Post by Johonebesus »

Of course the anti-abortion crowd is using this as an example of why abortion should banned. Obviously this illegal back ally "clinic" was able to operate because abortion is legal.
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Re: Butcher of Women in Philly Arrested.

Post by MKSheppard »

Simon_Jester wrote:The one thing I think any rational person can agree on is that there should not be no standards whatsoever, which is basically the regulatory regime that Gosnell operated in: he was in a total enforcement vacuum.
And why was he in a total enforcement vacuum? I suggest you read what I posted from the GJ report.
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Re: Butcher of Women in Philly Arrested.

Post by MKSheppard »

Simon_Jester wrote:I think if you're going to apply inspection standards to abortion clinics, the standards need to be tailored to what the clinics do and do not do.
Oh, the GJ report is quite specific on what standards that liposuction and colonoscopy clinics meet that Abortion facilities don't:
Those clinics, unlike abortion facilities, must implement measures for infection control (28 Pa. Code. §567.3 lists 17 specific procedures that ASFs must follow to control infection). They must use sterile linens (§567.21-24). They must keep premises and equipment clean and free of vermin, insects, rodents, and litter (§567.31). The regulations devote three pages to anesthesia protocols (28 Pa. Code §555.33).
Of course, the DA went into full McCoy mode right after:
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.
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Re: Butcher of Women in Philly Arrested.

Post by MKSheppard »

Johonebesus wrote:Obviously this illegal back ally "clinic" was able to operate because abortion is legal.
Except it was not a so-called back alley clinic.

If you had even bothered to read the GJ report, it has a image of the clinic on the cover page:

Image

It was also a licensed facility, in case you missed the part about it's license being revoked once the details of the case were made public.

Know what I personally find scary about this entire case? The fact that from 1993-near present, Abortion facilities were pretty much left to do whatever the hell they wanted by Pennslyvania.

I shudder to think of what else will be found following this widely publicized case bringing this kind of stuff to light.

Oh; and this case was in the Washington Post today, on page A2 as a little blurb.
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Re: Butcher of Women in Philly Arrested.

Post by spartasman »

I read this story last night, and the first time I hear of it on the news is a seven-second cover on Fox not ten minutes ago, in which they simply stated that it was a 'house of horrors' with little more in details about this guy. Of course, directly after that was a story about how twenty years ago the Gulf War happened. I know it was Fox News, but I expected a 'little' more coverage on something like... this.


P.S - Before you ask me why I was watching Fox news; both of my parents are Tea-Partiers, and they watch nothing else. Couple that with a small apartment, and ta-da.
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Re: Butcher of Women in Philly Arrested.

Post by Johonebesus »

MKSheppard wrote:
Johonebesus wrote:Obviously this illegal back ally "clinic" was able to operate because abortion is legal.
Except it was not a so-called back alley clinic.

If you had even bothered to read the GJ report, it has a image of the clinic on the cover page:
...

It was also a licensed facility, in case you missed the part about it's license being revoked once the details of the case were made public.

Know what I personally find scary about this entire case? The fact that from 1993-near present, Abortion facilities were pretty much left to do whatever the hell they wanted by Pennslyvania.

I shudder to think of what else will be found following this widely publicized case bringing this kind of stuff to light.

Oh; and this case was in the Washington Post today, on page A2 as a little blurb.
"Back ally" was a bit of hyperbole on my part due to it's association with illegal abortions. It was just a rhetorical phrase to highlight the absurdity of some of the anti-abortion arguments I heard today. Of course I saw the bit about the licensing, but the fact that he wasn't properly inspected and wasn't caught until now doesn't mean he wasn't breaking the law.
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