Wednesday, April 12, 2006

Another abortionist in trouble

RICHMOND, Va. (AP) The Virginia Board of Medicine has suspended the license of Dr. Reffat Kamel Abofreka of Annandale on accusations that he failed to provide proper care to obstetric and abortion patients.


The board alleges that in two cases he failed to determine the age of a fetus before starting to terminate the pregnancies. In both cases the board says he told the patients to go to the hospital, but failed to arrange for their transfer. ....

Other records indicate Abofreka has been disciplined by the board before. The board reprimanded him in 1998 in connection with disciplinary cases in South Carolina and Pennsylvania. ....

HT: Vital Signs

The summary of what the Virginia Medical Board has available is here. You can click on a link on that page to ask for downloadable PDFs of their documents.

The first says, "On April 3, 2006, a majority of the Bard agreed that the continued practice of medicine by Dr. Abofreka may be a substantial danger to the public health and safety..." This prompted them to deal with him by conference call rather than waiting until the next meeting.


Patient A (I'll call her "Arlene") went to Abofreka's office January 9, 2006 for an abortion. "Without performing diagnostic tests to ascertain the gestational age of the fetus, and instead relying only on a bimanual pelvic examination," Abofreka decided that Arlene was 12 weeks pregnant. Abofreka poked around in Arlene's uterus, trying to get the fetus out, before finally deciding to do an ultrasound, whereupon he discovered that she was actually 24 weeks pregnant. The board faults Abofreka for doing so late an abortion outside a hospital, as required by law, but more to the point, had Abofreka not initiated the abortion, Arlene might have elected to continue the pregnancy, since she had reached the point where her fetus had a good chance of surviving outside the womb.

At any rate, once Abofreka realized that he was trying to abort a fetus that was nearly in the third trimester, he simply told Arlene that she should go to a hospital. But Abofreka made no transfer arrangement for Arlene. She went to the hospital on her own, where an ultrasound confirmed that her fetus was 23.2 weeks. "The fetus was delivered," the Board states, "but failed to survive."


Patient B (I'll call her "Brandy") went to Abofreka on August 23, 2004. She believed that she was pregnant. Instead of performing a pregnancy test, Abofreka performed a vaginal ultrasound. "Dr. Abofreka noted in the patient's chart that he advised the patient that he does not deliver babies, does not do prenatal care, and only does sonograms and blood testing." Abofreka confirmed that Brandy was pregnant, but did not refer her elsewhere for care.

Brandy returned on September 20. Abofreka drew blood and sent it for testing, which came back "Prenatal Profile I". Abofreka also performed a vaginal examination and noted no signs of infection. Again, he sent Brandy home with no referral for care.

Brandy returned, and Abofreka performed ultrasounds and took her blood pressure, on October 18, November 16, December 14, january 11, and February 15. He charted the growth of Brandy's fetus, but again did not provide or refer her for proper prenatal care.

Brandy returned to Abofreka on March 1, reporting an infection. Abofreka did a vaginal exam, said he didn't see any signs of infection, and sent Brandy on her way, again with no referral for prenatal care.

On March 6, Brandy showed up at the emergency room for labor and delivery, naming Abofreka as her prenatal physician.

The board faulted Abofreka for performing repeated ultrasounds on Brandy with no medical purpose, since he was not providing any actual prenatal care to her.


Patient C (I'll call her "Carly") went to Abofreka on February 10, 2002, for a pregnancy test, which was positive. Carly requested an abortion, and Abofreka told her to return the following day.

Carly returned, and Abofreka initiated an abortion without performing any tests whatsoever to determine how advanced her pregnancy was. He was "unable to retrieve a satisfactory amount of tissue," so he stopped the procedure and brought Carly to an exam room for an ultrasound. This revealed "a cystic mass between the uterus and the left ovary which Dr. Abofreka suspected to be an ectopic pregnancy."

Rather than arrange for a transfer, Abofreka simply gave Carly a copy of the ultrasound and told her and her boyfriend to go to the nearest emergency room.

Carly went to the ER as instructed, where the mass was confirmed, and an HCG test performed which verified Carly's pregnancy. On March 3, a 6.6 week pregnancy was confirmed, in Carly's uterus. That meant that Carly was only three weeks pregnant when Abofreka had attempted to perform an abortion on her. This is too early in pregnancy to safely perform a surgical abortion because of the small size of the embryo.


An unannounced inspection of Abofreka's practice on June 14, 2005, with follow-up visits June 23 and July 14, found that Abofreka had no proper inventory of his drugs. He lacked current resuscitation certification. His informed consent forms had no information about them about the anesthesia. There was "no evidence that the personnel working in his office were trained in the emergency procedures." Abofreka had no transfer agreement with a hospital. He had no written discharge instructions for patients, and no contact information for them to take with them upon discharge.


An search of the North Carolina medical board site found that Abofreka had voluntarily surrendered his license there in 1994. I couldn't get the page of allegations to load. The Pennsylvania and South Carolina boards have nothing available online.

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