Monday, August 03, 2015

2009: Habitual Quack Kills California Woman

On July 28, 2009, 30-year-old Ying Chen, who did not speak English, went to Andrew Rutland's abortion facility in San Gabriel, California, for a safe, legal abortion. 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. 

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. Rutland injected Ying with Demerol, which he was not authorized the dispense in his clinic setting. 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. 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 said 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." 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." 

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 wereallowed 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.

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