May 28, 2013 — Maryland health officials investigating the death of a woman after an abortion late in pregnancy at a Germantown clinic found "no deficiencies" in her treatment at the facility, but they cited the clinic and 11 other facilities for a range of other issues, the Washington Post reports.
Case of Germantown Clinic
State health officials launched an investigation into Germantown Reproductive Health Services after the death of a 29-year-old woman on Feb. 7. The procedure in question was performed by Leroy Carhart, one of the few U.S. providers who publicly acknowledges performing abortions later in pregnancy, according to the Post.
In a letter to state legislative leaders on Friday, health department officials said that the investigation -- which included interviews with clinic staff; reviews of medical records, clinic rules and procedures; and a consultation with the state medical examiner's office -- "identified no deficiencies with respect to [the] complaint."
Results of Broader Investigation
However, a broader investigation of the state's 16 surgical abortion clinics found that the Germantown clinic was among a dozen facilities with numerous deficiencies.
The most common issues across all the clinics were failures to provide the medical credentials of clinic physicians, maintain a sterile environment at all times and document a discharge diagnosis in medical records. None of the deficiencies caused harm to patients, and all of the providers were certified to provide abortion care, health officials said.
Specifically, investigators found that nurses at the Germantown clinic were not properly trained to give sedation medication. One nurse's credentials had expired, and the clinic's medical director also lacked proper credentials. In addition, the clinic did not have sufficient emergency or sterilization procedures. The clinic said it had remedied the problems or had plans to do so, adding that the issues have not affected patients.
Health officials found life-threatening deficiencies at a separate provider, Associates in OB/GYN Care, which operates four clinics in Maryland. In March, authorities suspended the provider's license to operate at three locations for not complying with state regulations, but they reinstated them three weeks later for fixing the issues, which were related to emergency response for patients.
This month, officials suspended the licenses of all four clinics after they found "serious deficiencies in the medical oversight of patient care." For example, an unlicensed technician at a Baltimore clinic gave abortion medication to a patient without a doctor present and before the pateint had been examined, in violation of state regulations. The woman was 13 to 14 weeks pregnant.
Investigators later determined that it was "standard, unwritten protocol" at all four clinics to give abortion-inducing drugs to all patients who were at least 11 weeks pregnant, even if the patient had not been examined by a doctor and one was not present, the Post reports.
At an administrative hearing last Tuesday, the health department's chief regulator ordered the suspensions to continue, in part because the clinics' operator "did not accept responsibility" for the unwritten protocol and blamed it on a physician. Joshua Sharfstein, Maryland's health secretary, said, "We will suspend licenses when we feel like they pose a risk to patients" (Sun, Washington Post, 5/28).