Sunday, January 25, 2015

"Safe and Legal" in Queens, 2010

Photo of a radiantly-smiling young woman with a round face and honey-blond hair
Alexandra Nunez
Alexandra Nunez was a 37-year-old single mom from New Jersey. On January 25, 2010, she told her family that she was going to a doctor's office in Newark for a procedure to remove a cyst. Instead she went to A1 Medicine in Jackson Heights, Queens for an abortion. She was 16 or 17 weeks pregnant. The abortion was performed at 3:30 p.m. By the end of the day, Alexandra was at Elmhurst Hospital Center, dead from hemorrhage.

Her 19-year-old daughter, Daisy Davila, told the New York Daily News, "I'm upset because I never got a chance to say goodbye. She didn't want anyone to go with her. I made dinner and lunch ,,, hoping she would come back."

Eventually the medical board concluded that the doctor responsible for Alexandra's death was Robert F. Hosty. He had no hospital affiliation and hadn't taken any continuing medical education training since 2004.

Because of Alexandra's obstetric history, which included two c-sections, and the location of the placenta, Hosty should have known that it was unsafe to proceed with an abortion in an outpatient setting. Catastrophic complications are to be predicted, and the doctor must be certain that there is an adequate supply of blood for a possible transfusion, and a fully equipped operating room nearby in case an emergency hysterectomy is needed.

As a prudent physician would have suspected, the placenta had implanted deeply into the area of Alexandra's uterus that had been scarred by the prior surgery.

A red brick building with a music store on the first floor and a sign above the store in Spanish reading "A1 Ginecologica"
A1 Medicine in Queens
After the abortion, Alexandra began to bleed uncontrollably. Rather than seek the cause of the bleeding, Hosty administered medications, then stood by and did nothing while a nurse anesthetist intubated Alexandra and began providing oxygen. Nobody summoned an ambulance until over 45 minutes after blood began pouring out of Alexandra's body.

Paramedics arrived to find Alexandra still on the procedure table in stirrups, cold and gray and for all appearances already dead. Blood was still draining from her body into a pool on the floor. The only monitoring instrument in place was a pulse oximeter. The nurse anesthetist was administering oxygen, and because she was the only one who seemed to know what was going on, the emergency responders assumed that she was the physician. Nobody else was assisting the patient in any way.

The paramedics began a futile attempt to resuscitate Alexandra, but she was pronounced dead at the hospital.

Operation Rescue describes the facility where Alexandra's abortion was done as "located in a run-down building in a predominately Hispanic neighborhood," and was operated by Salomon Epstein. An employee at A1 insisted that all had gone well at their facility. "The patient was transferred to the hospital, she didn't die at the clinic. Nothing happened here." 

"Nothing happened." Except that a woman was fatally injured. It's like the thank you note that Steve Lichtenberg sent for the referral after Deanna Bell's death: "Uneventful D&E". A dead patient. "Uneventful." "Nothing happened."

A1 was an ambulatory surgical facility doing abortions and plastic surgery. They employed Hosty even though he had already allowed a gynecological patient to die by triggering massive bleeding then utterly failing to provide any effective lifesaving care.

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