Tauber agreed to reduce the fee and scheduled Gloria to return for a combination of abortion and tubal ligation on March 6.
What Were Her Realistic Options?
A prolife center also could have taken a holistic approach to Gloria's sad predicament. She was struggling financially. With her health problems she was probably also struggling to manage a household with so many children, even though the oldest were old enough to help take care of the youngest. The fact that she was raising her six children on her own indicates that she may have lacked the skills to identify reliable men that would help to support the children they sired. Her work skills seemed to be limited to more physical labor that her health wouldn't allow. Help finding a sedentary job would have resolved some of her problems. Abortion doesn't require a holistic approach but focuses on getting rid of the fetus and leaving the woman in her same unfavorable circumstances.
Dr. Spore expressed awareness that Gloria was a high-risk patient, either for an abortion or for carrying to term. But news coverage doesn't indicate that he referred her to a high-risk ob/gyn who would have been able to give her more realistic guidance. Was Spore so focused on the idea that the baby might have health problems that he fixated on the idea that the child should be aborted? Or was he just stuck thinking in that direction because Gloria had previously scheduled an abortion?
What would a high-risk ob/gyn have done? By the late 1970s, he or she certainly would have had access to ultrasound to better assess the health of Gloria's unborn baby. He or she would have had a better idea of the comparative risks of carrying to term versus aborting. If a high risk ob/gyn believed that an abortion was indeed the best option, Gloria would almost certainly have been admitted to a hospital for the procedure, and her medical assistance would have paid for it as medically necessary. Sending her to an abortion clinic was a shortcoming on Dr. Spore's part.
The Abortion and the First Signs of Trouble
Going into the abortion, Gloria's vital signs were good. Her blood pressure at 11:45 pm was 122/84 and her pulse was 84. Tauber was assisted by registered nurse Carolyn MacArthur and OR tech Cynthia LaGree.
Gloria's surgery was started at 12:05 pm. About 45 minutes into the procedure, there was a sudden gush of blood. Tauber inserted a scope through Gloria's navel to try to identify the source of the bleeding. LaGree said later that she observed through the scope as Tauber completed the abortion. The only injury she saw was a hole about half in inch long on the lower right side of the uterus. This nick was not enough to account for the amount of blood loss Gloria seemed to be suffering.
The surgery was completed at 1:25 pm, nearly an hour and a half after it was started. By then, Gloria's blood pressure had fallen to 80/60 and her pulse had risen to 96. This was a sign of internal bleeding. Tauber packed Gloria's uterus with medical gauze, which appeared to have controlled the bleeding. By this point, though, Gloria had lost an estimated 1500 cc's -- 3 units -- of blood. Tauber documented Gloria's condition as "borderline." He administered IV fluids, continued cardiac monitoring, and ensured that she was being attended by a nurse.
Delays and Transfusions
Tauber hand-wrote a note on her chart: "Plan -- Observe and transfuse. If deteriorates, transfer for hysterectomy." He ordered blood from Central Florida Blood Bank at 4:30 pm.
While waiting for the blood to arrive, Tauber called Orlando Regional Medical center. The resident on call instructed him to call the attending obstetric physician. So around 5:30 or 6:00 pm, Tauber called Dr. A. J. Herran to get clearance to admit her to ORMC. Dr. Herran approved the transfer. But Tauber decided to try to stabilize his patient at the birthing center.
Also at around 6 pm, Gloria's friend LeRoy Feaster came by with Gloria's two youngest children, expecting to take her home. By then, the first blood had arrived and Gloria was getting a transfusion. He was told that she would have to be kept overnight. LeRoy went back to speak to her. She reassured him that there had just been a problem with her blood pressure that was being addressed. She smiled as LeRoy gave her a goodbye kiss on the cheek.
Tauber administered a second transfusion, concluded that Gloria was recovering, and left his patient in the care of a crisis nurse and nurse MacArthur.
Gloria Seemed Stable
Tauber came back at around 9:30 on the morning of March 7. Gloria's vital signs had remained stable since the previous night. Though Gloria was sitting up on the side of the bed and had gotten up and showered, she still reported abdominal pain. Tauber attributed this to the laparoscopic surgery and kept Gloria for observation.
Nurse LaGree said that all signs of the bleeding had stopped. Gloria's abdomen was soft and not tender. She spent the afternoon watching TV and chatting with the nurse. She showed off pictures of her children and told LaGree that her oldest son had just gotten back from Job Corps and was going to be a help to the family.
At around 5:30, LeRoy Feaster came by again, expecting to take Gloria home. He looked into her room but decided not to disturb her because she was sleeping. He never saw her alive again.
The Final Catastrophe Plays Out
At around 6 pm, Gloria walked to the operating room to have the packing removed. Tauber removed it slowly, but about 3/4 of the way through the process there was a sudden massive gush of blood, and Gloria's blood pressure plunged. Tauber ordered meds to contract the uterus and told his staff to call 911 and to cancel an ordered unit of blood from the blood bank so that it would be available for the hospital.
While waiting for the ambulance, Tauber packed Gloria's uterus and vagina with more gauze. Nurse B.J. Caruth lowered Gloria's head so it was lower than her feet to direct more blood and oxygen to her brain. "Mrs. Small was looking around quietly, but obviously frightened, obviously in pain. She was instinctively trying to roll over. We reminded her to lie still and she said, 'OK, OK, OK.'"
The staff who contacted the ambulance dispatch gave contradictory instructions. She said she said that she that there was an hemorrhage and used the words "stat" and "emergency," but also said "to come without making a commotion about it."
This led to the ambulance being dispatched as "routine transfer -- no lights, no siren." It was half an hour until, light and sires blaring, the ambulance headed from the birthing center to the hospital. Gloria arrived, accompanied by Tauber, at 6:52 pm. EMS said that awake and talking, alert, but lethargic and weak.
Chaos at the Hospital
Reports of what happened next are unclear. Dr. Herran said that he was notified that Gloria was being transferred and began his drive towards the hospital. While on the way he got a notice on his pager that Gloria had arrived at the emergency room and gone into cardiac arrest. Different hospital staff give different accounts of whether the internal bleeding was diagnosed promptly, but though Gloria's blood pressure was 82/56 at 7 pm.
Tauber, not part of the hospital staff, was no longer able to provide care. He reported that he kept telling hospital staff that he'd ordered two units of blood that were at the blood bank across the street, but that hospital policy said they couldn't use blood that had been ordered based on type matching done at another facility.
Things were chaotic. Gloria's condition was clearly deteriorating rapidly. She went into cardio-respiratory arrest and was provided with resuscitation efforts. Her pulse was restored by the time she got her transfusion at 7:40 pm, but she was still being "bagged" to keep air going in and out of her lungs as she was brought into the operating room at 7:47 pm.
Herran arrived at the hospital and was briefed by staff as he prepared to operate. Another doctor, R. O. Vandyke, arrived to assist. The surgery began at 7:55 pm. Gloria's uterus was distended from all the gauze packing, which was poking out through a 1 1/2 inch tear. A resident photographed the damaged uterus as Herran surgically removed it. During the surgery, that lasted more than an hour, Gloria received five units of blood, but Herran estimated that this only made up for about a quarter of the blood the patient had lost.
Gloria was barely clinging to life as she was taken to the Intensive Care Unit at 9:50 pm.
Five minutes later she was dead.
The Immediate Aftermath
Some time after midnight the morning of March 8, Gloria's 19-year-old son, Terry, was called by a nurse and told to come to the hospital as soon as possible. Terry called LeRoy Feaster, telling him that the hospital had called. He had to get off work early, then, confused, he went to the birthing center rather than to the hospital. The receptionist directed him to the hospital. The hospital sent him to the medical examiner's office.
Assistant Medical Examiner Judith Bunker hemmed and hawed and finally told LeRoy that Gloria had died. As LeRoy broke down, he later recalled, Bunker told him that Tauber kept Gloria at the center too long and should have brought her to the hospital for surgery right away.
LeRoy contacted Gloria's sister, Shirley Johnson, who lived in DeLeon Springs.
On March 10, the medical examiner's office and police department met to discuss the case. But somebody at the state attorney's office leaked the story to WDBO, Channel 6 news. This led to concerns that Tauber would have a chance to destroy records to cover his tracks. A Channel 6 reporter said that he "sat in a van across the street [from the birthing center] with a sixpack of beer for four hours, waiting for the raid."
When it came at 11:25 that night, the media rushed up to the search party as they entered the birthing center, where three women were in labor.
The medical examiner said that Gloria's medical history should have precluded performing an abortion in an outpatient setting. The medical board faulted Tauber with failing to transfer to a hospital as soon as he'd had the bleeding stabilized with packing, and with trying to remove the packing in a setting where there was no blood available for a transfusion.
A court-appointed panel found Tauber negligent in Gloria's death.
The Consequences for Tauber
The repercussions for the 31-year-old Tauber were astonishing, given the legality of Gloria's abortion. He was dismissed from the staff of two hospitals, had his medical license suspended, and was charged with manslaughter. However, I have found no record that the case ever went to trial. Tauber relocated to Detroit, where he finally got around to completing a residency in obstetrics and gynecology, and went to work at the Scottsdale Medical Clinic abortion facility.
Gloria, like other Black women, faced a higher risk of abortion death than a white woman.
Sources:
- "An innovative concept, a controversial innovator," Orlando Sentinel Star, March 16, 1978
- "Doctor returning for hearing in abortion case," Sentinel Star, January 28, 1979
- "Autopsy: The tragic story of Gloria Small (page 1)," Orlando Sentinel Star, March 18, 1979
- "Autopsy: The tragic story of Gloria Small (page 2)," Orlando Sentinel Star, March 18, 1979
- "'Facts Omitted' in article on Gloria Small," Orlando Sentinel Star, April 1, 1979
Elizabeth O'Donnell was a homemaker who had come to the United States from Germany. On March 9, 1914, at the age of 33, she died at St. Elizabeth's Hospital from blood poisoning. 
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