Sunday, December 20, 2009

1997: patient, taken off monitor, dies after abortion

WAKE-UP has posted state medical board disciplinary documents against Dr. Earl McLeod, regarding the death of an abortion patient on December 21, 1997. WAKE-UP has identified her by name, but do not indicate where they learned her identity. I am therefore still working on verifying her name. But this is what I have learned:

On December 20, 1997, a 27-year-old woman went to Potomac Family Planning for a safe, legal abortion, to be performed by D&C. She was 6 weeks pregnant. She had no significant medical or surgical history, but had undergone a prior abortion performed by McLeod in 1995, under general anesthesia, with no complications.

McLeod's anesthesiologist, identified in records only as Dr. K., started an IV, and the woman was hooked up to a cardiac monitor, blood pressure monitor, and pulse oximeter. Dr. K administered Versed (for sedation and memory impairment), Sublimaze (a short-acting narcotic used for short-duration pain control), Propofol (a sedative for anesthesia), with Lidocaine, a local anesthetic.

The patient breathed on her own during the entire five minutes of the abortion. She was transferred to recovery at 10:10 a.m., still unconscious but breathing on her own. Her blood pressure was charted as 112/60 (normal), but her pulse was 103 (very rapid). A nurse identified only as Nurse W put an oxygen mask on the patient, but she was taken off the cardiac monitor and pulse oximeter when she was moved to recovery.

After the patient's vital signs were documented, another nurse, identified as Nurse H, took the blood pressure cuff off of her and put it on another patient.

Meanwhile, McLeod was in a second procedure room, doing an abortion on another patient.

At around 10:20 a.m., Nurse W noticed that the patient was still unresponsive. She told a nursing assistant to get Zoloft (an antidepressant) from the anesthesiologist, who was still in the second procedure room with McLeod. As the assistant was leaving, Nurse W change the request to one for Zofran (an antiemetic). Then Nurse W went into the procedure room herself to get the Zofran.

Dr. K gave the Zofran to Nurse W without evaluating the patient. There was no record that the patient had suffered any nausea or vomiting to warrant the drug in question. At about 10:25, Nurse W administered Zofran to the patient through her IV. Not surprisingly, administering an antiemetic did nothing to revive her.

Nurse W returned to the procedure room and asked Kr. K for Romazicon, a more appropriate drug, since it is used to reverse the effects of drugs used for anesthesia. Dr. K again provided the drug to Nurse W without examining the patient.

Nurse H went to take the patient's blood pressure, and she realized she couldn't find a pulse, and that the patient's pupils were dilated. She fetched Dr. K to assess the patient immediately. He found her unresponsive, with a blood pressure an alarmingly low 60/40. He stared a second IV and began to perform CPR, using a pediatric-sized bag-valve mask. Nurse H took over ventilating the patient, continuing to use the pediatric-sized bag-valve mask. This device would be unable to pump sufficient air into the lungs of a normal-sized adult.

Meanwhile, McLeod performed two other procedures before finally entering the recovery room and finding his staff performing inadequate CPR on the patient. He administered additional IV medications, and said that the patient was hooked up to an EKG monitor even though there was no documentation whatsoever of her cardiac rhythm. She was also not hooked up to a pulse oximeter that would tell the staff how much oxygen was in her blood. A pulse oximeter is standard monitoring for post-surgical patients and for patients needing emergency care; failure to use it on this patient was inexplicable. Also, despite the presence of two doctors, two nurses, and at least one nurses' assistant, nobody documented respiration, lung sounds, or any neurological evaluation, all standard for treating an unresponsive patient.

Dr. K told somebody to administer Epinephrine, Ephedrine, and Lidocaine -- all appropriate drugs for treating a patient in cardiac arrest.

Finally, at around 10:42 a.m., McLeod told somebody to call 911 -- something that should have been done as soon as she was found to be unresponsive. Paramedics arrived and found the patient in cardiac arrest. The anesthesiologist could not tell them anything about the patient's heart electrical activity, which he should have been noting on the EKG. They noted the use of a pediatric bag-valve mask, and the fact that nobody had put a breathing tube into the patient to ensure that air was being pumped into her lungs and not her stomach.

The medics immediately began appropriate resuscitation, intubating the patient, ventilating her with an adult-sized bag=valve mask, hooking her up to a cardiac monitor, defibrillating her, and administering appropriate drugs.

The medics transported the patient to Shady Grove Adventist Hospital, arriving at 11:09 a.m. The ER physician noted that the patient's pupils were fixed and dilated. After aggressive resuscitative efforts by ER staff, the patient's heart was restored to a stable rhythm, and she was admitted to the Intensive Care Unit. But despite their best efforts, she died at 4:15 a.m. on December 21.

The appalled paramedics reported McLeod to the medical board, which faulted him with failure to provide adequate and readily-available post-operative monitoring equipment, and failure to provide adequate emergency supplies. The board also required him to get his staff properly certified in CPR.

An interesting note is this: The medical board indicates that McLeod told them that when he first opened his abortion clinic, he contacted the state asking for guidelines for a freestanding abortion clinic. He was told, he said, that there were none.

McLeod also ran the Hillcrest abortion mill in Harrisburg, Pennsylvania, where Kelly Morse had died in 1996 after being inadequately resuscitated. Kelly's husband filed suit, noting, "No respiration rate was recorded, no pulse was checked and no blood pressure was measured. No EKG was applied. No cardiac monitoring was conducted. No pulse oximeter was applied. No intubation or emergency tracheotomy was performed." Evidently McLeod chose not to learn from Kelly's death the lessons that would have saved this Maryland patient's life.


OperationCounterstrike said...

Christina, you left out the disclaimer again: "This is just one case, an anecdote, which should not be taken as indicating a trend, nor of general abortion dangers."

Please correct immediately.

Tonal Bliss said...

OC, this case that Christina is posting is an example of a poorly run clinic. An anecdote of this kind in a different kind of medical clinic should be just as worrisome. However, in this case, it IS an abortion clinic. Standards for running such a clinic appear to have been too low. Proper equipment to handle an emergency was unavailable. Not even calling 911 immediately was done (which an ordinary citizen would have done). Staff was not properly certified. Only bits and pieces of vital protocol was followed.

This, OC, is what we call negligence. Whether it be in the abortion business or elsewhere, the light should be shed on it. It should be obvious to the reader that this anecdote is of a particular case. Any reader that does not know that should go and get a better education... Oh, right... you think everyone is an idiot. This is why EVERYTHING should have a disclaimer, right? :)

Christina Dunigan said...

It's not your blog, OC. I don't take orders from you.

OperationCounterstrike said...

Christina, I'm not trying to give orders; but you did say in our previous discussion that you were not trying to trick the reader into taking your anecdotes as indicative of any overall pattern, but were just trying to "humanize" the issue and let the readers draw their own conclusions. And I'm saying, now you have a chance to prove that.

SegaMon, Christina's sarcastic use of the phrase "safe and legal" implies that legal abortions in USA are not generally safe. That's specifically inviting the untrained reader to make an invalid generalization from this anecdote.

And no, I don't think everyone's an idiot. Just some people. Like you!

Tonal Bliss said...

..."safe and legal" is the phrase commonly used by those pushing for abortion rights. That's the only reason why she uses that term.

In this instance, I'm only an idiot for even confronting your thin arguments.

Ladybug said...

First of all, any patient coming into surgical recovery from under general anesthesia should never be immediately removed from cardiac and blood pressure monitering!

Continually evaluating and monitoring respiratory and circulatory requirements prior to, during, and following the procedure is essential.
-Monitor vital signs before, during, and after the procedure.
-ECG monitoring should be continuous for high-risk patients, during prolonged procedures, or during deep sedation.
-Consider continuous pulse oximetry for patients with comorbidities (eg, chronic obstructive pulmonary disease [COPD], asthma, congestive heart failure) or when high doses of sedatives or multiple drugs that may depress respirations are used.

-Observe the patient’s ppearance.
-Monitor airway patency.
-Monitor response to physical stimuli and verbal command.
-Measurement of blood gas level may be required.
-Consider capnography for high-risk patients.

It sounds like they did not have enough monitering equipment for all the patients present(refering to the blood pressure cuff being removed), and they were making potentially dangerous shortcuts.

Why the heck did the nurse first ask for Zoloft!? Maybe a sound-alike error? But any nurse worth her cent woud know the generic names of commonly-used medications and would know the difference. And Zofran? Maybe the nurse was concerned the patient would aspirate if she were to vomit?

There are many unanswered questions here. Why didn't the nurse ask the doctor to re-evaluate her patient, when she asked for the Romazicon, if she believed the patient's condition to be deteriating? Also, why wasn't the patient placed back on cardio-respiratory monitering at this time, if she was decompensating?

They were using a pediatric-sized bag-valve mask, which would of been insufficient on an adult!? What the heck!? Again, it sounds like they lacked proper equipment and why wasn't this patient immediately hooked up to a portable cardiac moniter (which a crash cart should be equipped with).

Why the heck wasn't McLeod immediately notified, since he was the physician who preformed the procedure on her?

You pinned it! It's unacceptable! Why don't they have documentation of this patient's readings from a cardio-respiratory and blood pressure moniter or a portable cardiac moniter (which should be standard on a crash cart)? Whether or not they actually preformed these monitering procedures is questionable, without the documentation. They could be held liable for the lack of documentation and not preforming the procedures.

*Slaps forehead* Duh! Finally someone administered the correct and potential life-saving medications.

Seriously!? They finally called 911 almost 25 mintues after the patient had began to deteriate? Yes! The doctors and nurses should of sent someone to call the paramedics as soon as she was found unresponsive and with poor vital signs, which they would of discovered sooner had she been on proper monitering. This would of likely have been a preventable death, with emergency assistance sought sooner, had the clinic staff been properly monitering her and trained in emergency treatment.

Also, off-topic, please pray for my uncle "Lloyd," a critical-care EMT who went to the hospital tonight with chest pains, only to be diagnosed with congestive heart failure.

Lilliput said...

This is from 1997. Is there a reason why you are not finding any newer cases. My gut feel is that things have obviously improved. I don't think they could hide something like this now as in this litigious society the lawyers would be all over it.

Tonal Bliss said...

Going by gut feeling? Hmm...

Ladybug said...

Oh? You mean like these deaths?

Kimberly Neil
Another Family Planning Associates Medical Group victims, died in 2000

Nicey Washington, age 26
Died after developing post-abortion sepsis in June 2000

L'Echelle Head, 21
Died after an abortion at Dayton Women's Health Services in October 2000. The Clinic had previously been operating without license

Haley Mason, 22
Killed herself after an abortion in 2001

Diana Lopez, 25
Bled to death after Planned Parenthood abortion in 2002

Adelle Roe, age 26
Given slipshod care, died in 2002

Stacy Zallie, 20,
Committed suicide after abortion in 2002

Brenda Vise, 38
Given RU-486 for undiagnosed ectopic pregnancy, died in 2002

Holly Patterson, 18
Died of sepsis after RU-486 abortion in 2003
Leigh Ann Stephens Alford, age 34
Bled to death from uterine perforation following an abortion preformed at a NAF clinic in November 2003

Hoa Thuy "Vivian" Tran, 22
Died from septic medical abortion in 2003

Chanelle Bryant, age 22
Died following complications of a medical abortion 2004

Tamiia Russell, 15
Died after after a second trimester abortion at Woman Care Clinic in Lanthrup Village

Christin Gilbert, 19, died from complications of a third-trimester abortion in 2005

Oriene Shevin, 34,
Died from sepsis following a RU-486 abortion in 2005

Cherish Roe,
Died from complications of a RU-486 abortion in 2005

Tara Roe,
Died from complications of a medical abortion in 2005

Laura Grunas, 30
Killed her baby's father, then herself in 2006, under emotional duress following a recent abortion

Wanda Roe,
Died from complications of a medical abortion in 2006

Edrica Goode, 21, died of infection in 2007

Laura Hope Smith, 22
Stopped breathing and died after abortion in 2007

Apparently you didn't do your research and were happy to stay ignorant of these deaths. And apparently abortion providers haven't gotten more careful.

Lilliput said...

Did any of these womens' families win courtcases? I don't think you can count suicide as negligence. What is the percentage of death compared to abortions performed ie is it lower or higher compared to any other surgical procedure? Either way I think these deaths are tragic and shouldn't have happened and that is why I support christine in writing this blog.

OperationCounterstrike said...

So here's a question:

Do you think Rachel understands that she has posted a string of anecdotes, and that anecdotes prove nothing?

Or do you think she imagines that she has made a point?

Vote now!

OperationCounterstrike said...

Another question: Rachel lists Christin Gilbert. Do you think she knows that Gilbert's death was not Dr. Tiller's fault nor Dr. Carhart's fault? That Dr. Tiller's numbers were so strong that he enjoyed the trust of the entire medical community in the Western world, with the exception of those who objected to the work itself, not to his skill at doing it?

My bet: no, Rachel doesn't understand this. She copies an anecdote from one web-page to another, and she imagines she has made an argument.

Typical semi-literate, semi-numerate right-to-lifer.

Kathy said...

Or perhaps option #3, which is, answering Lilliput's comment about "newer cases," duh!

Ladybug said...

I've got a reply in mind to OC, but I know better than to bait this troll. Thank you Kathy! One's denial of these women's deaths doesn't make these women any less dead from their abortions as a result of complications and/or doctors negligence.

"Did any of these womens' families win courtcases?"

You would have to research each case to find out.

"I don't think you can count suicide as negligence."

Perhaps not, however my point was that women CAN and DO experience depression and negative emotional reactions to their abortions, which can fall along a spectrum, from minorly intrusive to a deep depression with suicidal ideations. Factors which may influence her emotional outcome includes her prior belief system (inner feelings/beliefs), if she experiences pressure or coercion (subtle or otherwise) to have an abortion, how much partner/familial support she has for this pregnancy and her decision, and whether or not she has a prior mental illness, are just a few.

"What is the percentage of death compared to abortions performed ie is it lower or higher compared to any other surgical procedure?"

Well, since it's an elective procedure, then we would want to compare the mortality rate for other elective surgeries, however there are too many other factors, including surgery on different parts of the body carries different risks, for us to receive an accurate comparison. Besides, most of these abortion deaths were not just from forseeable complicatins, but the result of inappropriate responses to the complications, negligence and medical malpractice and many would of been preventable.

"Either way I think these deaths are tragic and shouldn't have happened and that is why I support christine in writing this blog."

Exactly! And this is why I support regulation of abortion clinics, just like any other outpatient surgical ambulatory center.

Lilliput said...

Kathy what do you think about the european countries like sweden,switzerland,denmark etc which are socialistic and have avery high standard of living?

Also, why aren't abortion clinics regulated?

Kathy said...

I think they're skating on thin ice; I don't want to live there; I like capitalism.

Someone else may have a better answer as to why abortion clinics aren't regulated, but I would imagine it would be because abortion advocates pitch a hissy-fit every time it's suggested, and they would claim that trying to make sure abortion clinics meet safety and other standards is some sort of back-door way to try to take the first step to eliminating abortion -- you know, the "slippery slope" argument.

Insert blog name here said...

Did this abortion clinic also offer "services" to children? I find it ironic that they have a mask meant for children when that's who they make their money killing.

And many an error has been made using the brand names of the drugs. If the nurse wanted to ensure she got Zofran she should have asked for Ondansetron.

OperationCounterstrike said...


RE: "Well, since it's an elective procedure, then we would want to compare the mortality rate for other elective surgeries, however there are too many other factors, including surgery on different parts of the body carries different risks, for us to receive an accurate comparison. "

That's mealy-mouthed waffle. You compare the hazards of ANY procedure (elective or not) to the hazards the procedure PREVENTS. That means you compare abortion-hazards to the hazards of childbirth, which are more than ten times worse in pretty much all respects. (See for instance


RE: "abortion clinics not regulated"

What NONSENSE! Where did you get such a silly idea, or did you just make it up??? Abortion clinics hold medical licenses and they are subject to the same regulations, and the same oversight, as any other free-standing medical facility.

Tonal Bliss said...

OC, I don't get how some articles, like the one you provided, can be posted up on supposed respected medical websites. Why do I say that?

So many important studies to support their claims are on material that is GREATLY outdated. This article was written in 2004, yet material referenced to support their claim of NO psychological aftereffects were MORE than 10 years older than the article. Two articles were 14 years old, another was 12 years old.

In other instances, the article doesn't even supply a source for the information provided (such as the seemingly made-up number of 50,000-70,000 women die because of "unsafe" abortions in developing countries). Also, no source was provided regarding the legality of the procedure. "Abortion" was defined as occurring before viability; yet we know that there are many legal abortions that occur after viability.

Interestingly, on the issue of life, this article made an interesting concession: "Regrettably, [the trimester system] has no basis in biology, and the distinction between first- and second-trimester abortion remains blurred after 3 decades." Then what DOES have a basis in biology? Hmm...

I truly wish that these articles were a bit more forthright regarding the possible complications and used much more up-to-date information which is usually standard in other medical journal articles. And I wish that there were less articles that were clearly BIAS (such as "Fake abortion clinics: the threat to reproductive self-determination" which calls for the shutting down of CPCs... hmm... what about the false information and/or lack of information that Planned Parenthood so often hands out to their patients!?)

Or, for example, the immediate denial of any kind of possible link between abortion and breast cancer. Only one source was provided. I found a source which shows that the relationship between INDUCED abortion and breast cancer is unclear (Is there a link between breast cancer and abortion: a review of the literature), two which showed increased risk for breast cancer (Abortion and the risk of breast cancer: a case-control study in Greece, The association between induced and spontaneous abortion and risk of breast cancer in Slovenian women aged 25-54), and then others that indicated no increased risk (Induced and spontaneous abortion and incidence of breast cancer among young women: a prospective cohort study). Had the journal article author had been honest, it should have been said that there are many conflicting studies and many that state that the link is unclear.

I'm working too hard to please you, OC. I think I'll stop now. :)

Regardless, this particular case shows negligence and should be an example of what should not be followed. Had this clinic been properly regulated and properly inspected, the death of this woman could definitely have been avoided.

Tonal Bliss said...

The author Dr Creinin is an abortion doctor. The author Dr. Grimes has gotten shining rewards from ACLU, NOW, PPFA, and many other pro-abortion groups for his involvement in the abortion industry; it is unclear whether Grimes performs abortions. I'd say that these two authors certainly have a little bit of bias... (as would I, lol)

Tonal Bliss said...

OC, I should have never looked at your blog. You were gleefully referring to the murder of James Pouillon that a pro-lifer wanted to be shot and killed!! OC, I may get angry at you at times, but I never joke about people like you getting killed! Unless you respond with an apology and the removal/revision of that blog post, I'm not talking to you anymore, period.

OperationCounterstrike said...
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OperationCounterstrike said...
This comment has been removed by a blog administrator.
OperationCounterstrike said...
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Tonal Bliss said...

Calling us all murderers (when we don't kill anyone), stating that specific pro-lifers want to be killed (like the one who claimed to have had a knife brandished to her), and JOKING about the murder of a person (every person is a person no matter how crazy) all disqualify me to talk to you.

God bless you. I'll be praying for you. You are a certified nut-job.

Christina Dunigan said...

Sega, as far as I know Grimes continues to be a practicing abortionist. But I will say this for him: He published what he found, even when it wasn't favorable to his pet cause of more, and government-funded, abortions.

OperationCounterstrike said...

GG, what are you talking about? What did David Grimes publish that was unfavorable to his cause?

Not that I'm surprised, he's a very competent, objective medical innovator, but I'm curious what you are talking about.

Christina Dunigan said...

OC, just off the top of my head, he published the study they did that had expected to find that the Hyde Amendment led to an increase in abortion-related hospitalizations. They found the reverse, and Grimes and Cates published anyway. He also published a follow-up on his "typical abortion patient" who ended up back for another abortion.

So while I have a beef with Grimes and his cheerleading for abortion -- and making excuses for quack abortionists -- I have to credit him with publishing those findings unfavorable to his pet cause.

OperationCounterstrike said...

Hee hee! Ok, Christina, I'll bite. What excuses has Dr. Grimes made, for which "quack abortionists"??? Do tell.

Oh, and when you say you "credit" him, remember, he does his studies on government grants. If he were to withhold findings he didn't like, he'd be looking at some pretty serious criminal charges.

I obviously haven't read the study about the Hyde Amendment, but I'll bet any amount you like that it points out that there are lots of possible reasons for hospitalizations to drop during the time following passage of the Hyde Amendment. (See CONFOUNDER, definition of).

Christina Dunigan said...

Grimes made excuses for abortionists who let patients bleed to death, saying that if the law hadn't required that late abortions be performed in hospitals, the doctors doing the abortions illegally wouldn't have been afraid to send their hemorrhaging patients to the hospital.

And YES, I do credit him for publishing the data they gathered on the impact on the Hyde Amendment. It was actually a very well constructed study. They compared hospitalizations for abortion complications in states that picked up the tab for elective abortions after Hyde, versus those who simply allowed government funding for elective abortions to end. They found a DECREASE in the number of hospitalizations for abortion complications in states that DID NOT pay for elective abortions, while states that DID pick up the tab kept hospitalizing medicaid-eligible patients at the same rate. They looked for other factors -- increases in pregnancy and birth related complications in non-funding states -- and found none. And Grimes and Cates published their findings rather than bury them.

Though you're telling me that this was something they were forced to do. Here I was thinking they were just being honest. Should I have known better than to expect honesty from an abortionist?

OperationCounterstrike said...

No, you should know better than to be surprised by a professor of medicine reporting his results objectively.

OperationCounterstrike said...

No, you should know better than to be surprised by a professor of medicine reporting his results objectively.