Professional negligence

Abortion | Health Department documents show lack of inspections at New York abortion centers, and multiple problems at the few that were visited
by Emily Belz
Posted 4/15/14, 12:59 pm

NEW YORK—More than 1,700 pages of newly released New York State Department of Health documents show that some abortion centers in the state were not inspected at all over the last 12 years. Of the few inspections it made, the department found many violations, and in one case temporarily ordered a surgical abortion center to cease performing abortions. The trove provides details of violations at abortion centers since 2000.

The Health Department never inspected eight of the 25 abortion centers it oversees from 2000 to 2012. It inspected five centers only once, and made a total of 45 inspections statewide over those 12 years. During that time span, the state recorded more than 1.5 million abortions. In response to the documents, the Health Department said it would re-inspect all 25 facilities “within the coming days.” The department said it would strive to inspect all abortion centers every four years. 

New York State Commissioner of Health Nirav Shah announced last week that he plans to resign in June. Shah, who is taking a job in the private sector in California, hasn’t given a reason for leaving his post, but Democratic New York Gov. Andrew Cuomo attributed it to the low salary the state pays. In addition to the failure to inspect abortion centers, Shah had also come under fire for delaying the release of a study to authorize fracking in the state. A day before Shah’s announcement, Republican gubernatorial candidate Rob Astorino had demanded Shah resign based on the report on abortion centers as well as the fracking controversy. Cuomo faces reelection this year.

The document release comes as a result of a Freedom of Information Law request from the Chiaroscuro Foundation, a pro-life group that tracks data on abortion in New York. The foundation provided the documents first to the New York Post, and then released them to others last week. The department would not release the documents until a judge ordered it to do so, and then released the information with all the identifying information for the abortion centers redacted. Chiaroscuro is working on an appeal to the judge to have the redacted information released, on the grounds that women should know if an abortion center has health violations.

“The lack of inspections is really quite frightening,” state Sen. Diane Savino, a pro-abortion Democrat, told the Post. “These are facilities where women are seeking medical care. We shouldn’t allow these medical facilities to take second fiddle to inspections for tanning salons and restaurants.” 

The triple murder conviction of abortionist Kermit Gosnell in nearby Philadelphia pushed Chiaroscuro president Greg Pfundstein to file the request to obtain the documents from the state. Gosnell’s center, where he was convicted of snipping the necks of babies born alive, hadn’t been inspected in 15 years. In fact, Pennsylvania’s health department had not inspected any of its abortion centers in 15 years. Pfundstein wondered if similar health inspection negligence was happening in New York. 

The few inspections New York conducted revealed serious problems, even if “there may not be fetuses in a jar in the basement,” Pfundstein said, adding that even those who want to outlaw abortion completely should want regularly inspected centers for now.

A review of the 1,700 pages of Health Department documents shows that most violations were incomplete employee personnel and patient files, problems with physicians’ credentials, broken equipment, or expired drugs. But there were more troubling problems. One facility in Queens, Choices Women’s Medical Center, was fined $20,000 in 2000 and told to cease surgical operations after inspectors found it was performing “hasty” abortions. That wasn’t the first time Choices had problems: In 1994, a patient died after a second-trimester abortion. Choices remains open and operating today. (The Health Department blacked out any identifying details about the centers in the documents, but the violations at Choices in 2000 were reported publicly.) 

“These deficiencies represent serious systemic problems that pose a significant risk to the welfare and safety of the patients treated by the facility,” the Health Department wrote at the time. “For example, the surgery schedule does not allow adequate time to assess patients prior to surgery, to monitor patients, or to clean and prepare the room for the next patient. Surgical equipment is not properly maintained, including anesthesia monitoring equipment that was not functioning. Nurse staffing is inadequate. Physician credentialing and quality assurance are ineffective. … Combined, the deficiencies represent an intolerable situation that cannot continue to exist.”

Another unnamed abortion facility was fined $60,000 that year and also ordered to temporarily cease surgical operations. 

The documents revealed that one center in New York City couldn’t find consent forms from several patients who had obtained abortions, and two of 95 patients surveyed were not told of their right to view an ultrasound. Several centers lacked written policies or training on recognizing abuse in clients. A woman complained that she contracted lice after an abortion at another center. The inspector following up on her complaint noted that the abortionists were not washing hands adequately between abortions, and no licensed nurse was present as required. Another complaint said abortionists were reusing one-use tubing—the inspector’s findings were blacked out but the complaint was “substantiated.” 

Several abortion centers neglected to label fetal remains. An inspector at another center found opened, unlabeled vials of drugs. One facility was distributing Plan B (the “morning-after” pill) in its lobby in 2007, two years before Plan B was initially approved as an over-the-counter drug. 

After someone filed a complaint against an abortion center in 2013, a Health Department official wrote back: “We will continue to monitor the facility through our routine surveillance activities.” 

Even for abortion centers with minor violations, the documents showed the grisly details of what they do. One center’s memo updating the its practices urged those performing abortions to make sure they removed all the body parts out of the womb. The form included a checklist of body parts: “caput [head], spine, thorax, four extremities.”

Abortion is legal up to 24 weeks in New York.

Pfundstein said Chiaroscuro would follow-up with the Health Department to see that it did in fact inspect the 25 abortion facilities and ask what violations it found. 

The Guttmacher Institute estimates there are more than 200 abortion providers in the state, though New York only has the responsibility to inspect the 25 surgical abortion centers. The Health Department only requires abortion centers that do surgical abortions, not first trimester abortions, to obtain a license for performing abortions. The department also does not inspect private practices, so a licensed physician can perform abortions in his own practice without an abortion license. Some OB-GYNs perform abortions. The state relies on professional accreditation agencies to regulate private practices. 

Unlicensed centers “deliberately exclude themselves from licensing and oversight,” Pfundstein said. “I don’t think that’s acceptable.” 

Emily Belz

Emily is a senior reporter for WORLD Magazine. She is a World Journalism Institute graduate and previously reported for the The New York Daily News, The Indianapolis Star, and Philanthropy magazine. Emily resides in New York City. Follow her on Twitter @emlybelz.

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