Sunday, December 07, 2008

Another death from Westlaw

Dr. Claude C. Long ran a rather fishy medical practice in San Francisco. He, his wife, and a relative named Ann Fisher, were charged with the murder of Genevieve Arganbright. Long admitted -- once he'd been caught -- that Genevieve had died while he'd been performing an abortion on her. The jury acquitted Mrs. Long and Ann Fisher, but found Dr. Long guilty of manslaughter.

Long had an office on Valencia Street, and another on Haight Street.

The one on Valencia Street was in a middle flat of the building, with his name on the window and a telephone listed in the city directory. A woman named Ann Fisher, who was in some way related to Long and his wife, managed this office for him, scheduling appointments for patients who had walked in or telephoned. Mrs. Long's sister-in-law, Mrs. Spence, who lived in a flat upstairs of this office, reported that Mrs. Fisher lived at the rear of the Valencia Street office. However, no medical or surgical equipment was found at the site during the police investigation. Long said that he seldom saw any patients there at all. Mrs. Spence said that she had in fact never seen Dr. Long at the premises.

Long actually saw his patients at the Haight Street location, in premises rented by his wife under the name of Young. There was an unlisted telephone at that location. Long made a habit of parking his car at a garage about seven blocks away, often having the garageman drop him off about a half-block from the Haight Street office. When he was arrested, Long had keys to the back doors, but not the front doors, of the Haight Street building. When they searched the building, police found every evidence that Long was practicing medicine there, with "various medicines used in connection with operations on women" found there, and abortion instruments found in a closet. The actual instruments used in the fatal abortion had been hidden by Long the night of the death, but he eventually turned them over to the police.

Genevieve was, according to her husband, about 2 1/2 months pregnant at the time of her death. She had been in good health, athletic, and in the habit of taking long hikes, dancing, swimming, and playing tennis. She worked for the W.P.A., and kept house for the couple and their child. She had not shown any overt symptoms of having a bad heart.

On May 19, 1937, Mr. Arganbright heard his wife make a phone call to Dr. Long's Valencia Street office and make an appointment to go there between 2 and 4 that afternoon. The couple arrived and were let in by Mrs. Fisher, who took down Genevieve's name and asked her who her companion was. Mrs. Fisher then took Genevieve into another room, where Mr. Arganbright overheard Fisher asking his wife how long she had been pregnant and instructing her not to bring her husband with her for her appointment the next night.

The next day, May 20, Genevieve went to work and returned home as usual. At about 6:45 that evening, she left, telling her husband she going for her abortion. She was planning to go by streetcar to the Valencia Street office, where a driver was to take her to somewhere on Haight Street for the actual surgery. She brought with her $50 that she had borrowed to pay for the abortion.

That was the last time Mr. Arganbright saw his wife. Nobody at Dr. Long's practice called to tell him that his wife had died on the operating table.

Dr. Long did have Mrs. Fisher make a phone call: to a Dr. Goldsand. Some time about about 10:25 p.m., she called him and asked him to come to the Haight Street office to help with a very sick patient. He arrived in a little under ten minutes. Mrs. Fisher met him and brought him upstairs to a bedroom where the body of Genevieve lay in bed, dressed in street clothes, partially covered with a blanket. Both Dr. Long and his wife were there. Long asked Goldsand to examine Genevieve. He did so, confirming that she was dead. He administered drugs to try to revive her, to no avail.

Long asked Goldsand to sign a death certificate, but he refused, noting that since Long had been treating Genevieve, it was his duty to perpare and sign a death certificate. Long did not respond, and Goldsand left the premises. Long later testified that he was left with the impression that Goldsand would sign the death certificate, a claim the jury clearly didn't believe.

The next call made from Long's office was to an undertaker's office. When two employees arrived to collect Genevieve's body at about 2:30 the morning of the 21st, Dr. Long wasn't present. Mrs. Long and Mrs. Fisher were there, and identified themselves as "very dear friends" of the dead woman. They said that the woman's relatives had left, but would contact the undertaker in the morning to complete the funeral arrangements. They said that Dr. Goldsand had been the attending physician, caring for the patient for at least half an hour before she died of a heart attack. The undertaker's men wanted a phone to call Dr. Goldsand and verify this, but they were told that there was no phone, and the Dr. Goldsand said that everything was in order and that he would sign the death certificate in the morning.

The men took Genevieve's body to the mortuary, where the embalming was done in the morning. But when no relatives called to finalize arrangements, and nobody produced a death certificate, the undertaker notified the coroner. The employees at the undertaking establishment didn't notice anything about Genevieve's body that would lead them to believe that she had died from any reason other than a heart attack.

While things were getting squirrely at the mortuary, Dr. and Mrs. Long were making tracks. They registered at the Chancellor Hotel under the names of Mr. and Mrs. C. Young of Sonora, California. But when they were told they'd have to vacate the room by 4 p.m., they went to the Cecil Hotel and registered there under assumed names.

Nobody had even tried to contact Genevieve's husband.

Late in the afternoon of the 21st, Mr. Arganbright called the Valencia Street office and spoke to Mrs. Fisher. She said that she knew nothing of Genevieve's whereabouts, and that Dr. Long had left town. It wasn't until later that day, when the police arrived, that Mr. Arganbright learned that his wife was dead.

Dr. and Mrs. Long were arrested at the Cecil Hotel on May 22, where they were found registered under their proper names this time. In the mean time, Mrs. Fisher fled, and was later apprehended in Nevada City.

Neither Mrs. Long nor Mrs. Fisher took the stand during the trial, and both were aqcuitted. Dr. Long testified, and the jury didn't find his testimony particularly credible.

Long argued that Genevieve had died of a heart attack brought on by her long standing mitral stenosis, and that the abortion he'd been performing had only been intended to save her from the risk of death from the stress of continued pregnancy and labor. The abortion, he contended, had been perfectly legal, and had been performed with all due care.

The prosecution argued that the abortion had not been medically indicated by Genevieve's heart condition, and that even if it had been, Long's lack of due diligence had caused her death anyway. If the abortion had been elective, and thus illegal, Long was guilty of murder in Genevieve's death. If the abortion had really been to try to prevent Genevieve's death from pregnancy stress on her heart, but had been negligently performed, Long was guilty of manslaughter. And if the abortion had been medically indicated and properly performed -- if Genevieve had died from her pre-existing heart condition -- then Long was not guilty of any crime.

The autopsy performed on Genevieve did note that she had mitral stenosis -- a heart valve constricted due to previous infection. Mecical witnesses testified that as mitral stenosis progressed, it would cause the heart to work harder and faster and to become enlarged. After a while, the heart is unable to compensate, and the patient dies. However, they noted, before a patient dies from advanced mitral stenosis she will show signs of a heart condition, such as shortness of breath and discoloration of the skin.

Long testified that Genevieve had first come to him in March, and he had diagnosed the mitral stenosis. He said he had considered her condition to be borderline, that her heart was adequately compensating for the restricted valve, but that she could decompensate and die at any time. He was unsure if she was pregnant, and told her to return in two weeks so that he could determine if she was pregnant and if she was, perform an abortion to prevent her death from the mitral stenosis. She had not returned until the 19th, when she'd made the abortion arrangements. There was no record of this March office visit; Long held that he'd made a record and implied that it had vanished when the police had raided his office.

Genevieve's husband stood by his testimony, that the visit of the 19th was the first time his wife had gone to Dr. Long's practice.

Long did not deny that he treated Genevieve on May 20. He said that she had not come specifically for an abortion, but was certain that she was pregnant, and that she was constantly tired, with chest pain, palpitations, and shortness of breath, all indications of heart problems. Long said that he then informed Genevieve that her heart was in very bad shape and that he recommeneded an immediate therapeutic abortion to prevent her death. The defense also pointed out that Genevieve had sought a consultation at the Mt. Zion Hospital Clinic in 1933, believing that she might be pregnant, and that doctors there found that she was not pregnant but would have recommended an abortion had she been.

Long described the abortion as he performed it, and indicated that Genevieve's heart simply stopped during the procedure and he had been unable to revive her. He gave excuses on the stand -- not noted in Westlaw documents -- about the reason he didn't document the pre-abortion examination that supposedly verified a dangerous heart condition, about why he'd fled with his wife and assumed a false name, about why he kept one dummy office with a listed phone separate from his actual practice where there was an unlisted phone, why he'd tried to get Goldsand to sign the death certificate, why he'd not contaced the widower, and other actions that would not have been undertaken by an innocent man.

Expert testimony agreed that Genevieve did indeed have mitral stenosis, but there was no agreement on whether or not it warranted an abortion. The surgeon who performed the autopsy, and a pathologist from the coroner's office, both testified that Genevieve's heart was not at all enlarged. Her mitral stenosis seemed stable, and their expert testimony was that Genevieve would have likely tolerated pregnancy and delivery quite well. Several other physicians testified that there was nothing in Genevieve's autopsy or medical history to indicate that the mitral stenosis posed any threat to the young woman's life. Mr. Arganbright, other family members, and Genevieve's co-workers all testified that she had been in good health, showing none of the shortness of breath or other signs that would indicate that her heart was in poor shape.

In fact, the pathologist and several other doctors testified that Genevieve's heart had stopped not due to heart disease, but due to excessive blood loss. Expert testimony also pointed out that Genevieve already had the mitral stenosis since childhood, well prior to the birth of her child in 1932, and that she had tolerated pregnancy and labor quite well. A cardiologist testified that Genevieve's mitral stenosis was well-compenstated and stable, not posing any threat to her life.

Though expert witnesses conceded that some doctors simply recommended abortion for all patients with mitral stenosis, abortion would only be properly recommended if a heart specialist examined the patient and concluded that she was decompensating and in danger.

All of this would be germaine to a murder conviction, which depended on Long proceeding wih an abortion not necessary to try to save the woman's life. But there was also the matter of the real cause of death. Genevieve's cervix was lacerated and torn away from her uterus, with additional damage to the vagina and portions of the placenta torn loose and hanging out through the tears. Expert testimony indicated that a proper therapeutic abortion for a patient with heart troubles would involve hospitalizing her and performing the surgery under general anesthesia so as not to cause undue stress to the heart from excessive pain. Performing an outpatient abortion on an ailing patient meant performing a risky procedure without access to emergency facilities. In fact, Dr. Carr, the pathologist, testified that a patient sick enough to require an abortion would also have been too sick to simply perform one on the spot; a conscientious physician would have sought a consultation with a cardiologist, and would have hospitalized the patient for some time before the abortion in order to ensure that she was strong enough to survive the surgery. He also noted that the agony of having one's cervix ripped off would be enough in itself to cause shock in a patient with a weak heart. All of these factors were indicative of lack of due diligence on Long's part in performing the abortion, regardless of his reasons for performing it. At the very least, if he really was performing the abortion due to concerns about Genevieve's heart problems, he was guilty of manslaughter for performing an outpatient surgery and ripping his patient's internal organs so badly.

Long was granted his request for a new trial.

For more on pre-legalization abortion, see The Bad Old Days of Abortion

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1 comment:

belinda said...

I have just read your profile on your other blog. Your a really amazing person. Thank you for standing up for the babies. God bless you Belinda