Ying was 16 or 17 weeks pregnant by examination. Rutland didn't document when Ying's last period was, nor did he document her height and weight. He didn't include an ultrasound report in her chart. Her chart did, however, include two signed consent forms -- for a first-trimester abortion.
Because of how advanced Ying's pregnancy was, Rutland was going to insert laminaria, which are sticks of dried seaweed, in Ying's cervix to dilate it for the procedure, which Rutland planned to perform about six hours later, when the laminaria had sufficiently dilated the cervix. Ying asked for pain medication for this procedure.
Rutland injected Ying with Demerol, which he was not authorized the dispense in an unauthorized setting. He had brought the drug from his Anaheim office. Rutland didn't document the administration of Demerol in Ying's chart.
He positioned Ying for the laminaria insertion procedure, and injected her cervix with four injections of lidocaine, which he had also brought from his Anaheim office. Within minutes of the injection, Rutland told the board, Ying's arms and legs contracted, but she was alert and responsive, with good blood pressure. Rutland started an IV.
About ten minutes later, Ying was having some trouble speaking and breathing. Rutland told an acupuncturist who worked at the same office to call 911. Ying went into complete cardio-respiratory arrest. Clinic staff reportedly performed CPR, but when paramedics arrived, they reported that nobody was providing her with care. The medics took Ying to the hospital, where she died six days later of lidocaine toxicity.
In his statement to the medical board, Rutland said that he wasn't aware that the clinic even had a crash cart, which was kept at the back of the facility. The crash cart in question was stocked with expired medications. Rutland didn't use his own crash cart, which he'd brought from his Anaheim clinic, because he'd left it in his car.
Nobody at the facility was certified in CPR.
The California medical board found that Rutland has been operating in a facility that wasn't adequate equipped for emergencies, which "casts doubt on his professional judgment." The clinic, which Rutland owned, lacked an appropriate municipal license. Rutland didn't carry malpractice insurance, and had lied to the DEA about his medical license having been previously suspended. The board also found that Rutland "administered Lidocaine without knowing the safe dosage range or maximum safe dose" and that his "response to the medical crisis was inappropriate in that he failed to recognize Lidocaine toxicity in a timely manner, did not give the patient an oxygen mask, and delayed in calling the paramedics." They also noted that Rutland failed to report both Ying's hospitalization and her death to the medical board, as required by law.
Dr. Rultand acknowledged that the incident was terribly unfortunate, but asserted that everything he did was within the standard of care. Dr. Rutland denied operating a medical clinic on the premises, despite a sign on the door that said "Rutland MD Medical Clinic." Dr. Rutland denied owning the medical clinic where the incident occurred. Dr. Rutland argued that the nature of the procedures he performed did not require him to have malpractice insurance and did not require that the clinic be equipped for serious emergencies. Dr. Rutland claimed he administered, not dispensed the Demerol, and that doing so was not in violation of DEA regulations.
Although Administrative Judge James Ahler said that Rutland "presents a risk of danger and there is a likelihood of injury to the public" if he were allowed to continue to practice, the medical board failed to revoke or even suspend his license. Instead, in their January 7 hearing, they just banned him from performing any more abortions, performing other surgeries, or delivering any more babies. They will decide at another time whether or not to take further action.
California Deputy Attorney General Douglas Lee said that in his care of Ying Chen, Rutland "committed repeated negligent acts", and said that he had a history of dishonesty and corruption, including lying to patients and to authorities.
Rutland argued that banning him from performing abortions was uncalled for on the grounds that he wasn't actively performing an abortion on Ying when she suffered the fatal mistake. His lawyer, Peter Osinoff, asked the judge to give weight to the 100 abortions Rutland had performed without incident over a two year period.
This was not Rutland's first run-in with the medical board. He had surrendered his license in October of 2002 after allegations of negligence, misconduct, and incompetence in his treatment of pregnant women, gynecological patients, and newborns. Two babies died, one in January of 1997 and one in July of 1999. The board investigated reports that Rutland performed unnecessary hysterectomies, lied to patients, and had sex with patients in his office.
One of the infants who died, Jillian Broussard, suffered spinal cord injuries while Rutland was using forceps to deliver her. She lived six days. Her death ultimately led the medical board to revoke Rutland's license in 2003. Jillian's parents, who were present at the recent medical board hearing, lamented the reinstatement of Rutland's license in 2007, and the board's failure to revoke his license in the wake of Ying Chen's death.
"I think his victims and the public needed to get full peace of mind today, and they didn't," Kathy Broussard told the Orange County Register. "He still has a practice in Anaheim. He's still allowed to do gynecological exams and consultations. It's appalling." Scott Broussard told the paper, “There’s the making of a mistake, but then there’s the way that it was made and the reaction by him afterward. He was not a man of honor or integrity… The responsibility for this death is on the medical board, to be shared with Dr. Rutland. They’re supposed to protect the public and they have failed.”
Prolifers in California had been complaining since early March of 2009 to the Medical board about Rutland, who was running an abortion clinic in southern California without another physician supervising him, in violation of his board probation. This facility was at the same location as the illegal abortion mill operated by Bertha Bugarin, who had been convicted of performing unlicensed abortions there. Rutland was also reported by prolifers to be operating at another abortion facility in Chula Vista.