Saturday, February 06, 2010

Pendergraft's license revoked. Again. Will it stick this time?

HT: Live Action

Operation Rescue summarized the case thus, and included a copy of the medical board document in question.

Pendergraft owned and operated EPOC, an Orlando abortion facility. "This facility is not a hospital"

Patient S.B. (I'll call her Shayla), age 27, first went to EPOC on December 19, 2005, to ask about an abortion. She left the facility without deciding to go through with an abortion. On February 3, 2006, Shayla returned to EPOC for an elective abortion. This was Shayla's fourth pregnancy; she had three previous live births by c-section.

Staff did a medical history, physical exam, and ultrasound, and determined Shayla's pregnancy to be of 19 weeks. She was given Cytotec, which "helps soften and dilate the cervix to induce labor", along with instructions on how to take it, and was sent home. She returned on February 4, as originally scheduled, but because she was late, she was rescheduled for February 6.

Shayla returned on February 6 for more Cytotec. Her treatment continued through February 7. Pendergraft was assisted in treating Shayla by medical assistant Carmita Etienne. Shayla was given more Cytotec, along with Demerol and Phenergan. Pendergraft did not have a current valid DEA number "to prescribe, order or administer controlled substances."

The treatment plan called for Shayla to be given 200 units of Cytotec every four hours. But Pendergraft ordered an additional dose two hours after a prior dose. "The total amount of Cytotec administered was excessive." Throughout all of this, Shayla's cervix did not dilate as expected.

Cytotec "causes cervical dilation and uterine contractions, and ... generally results in passage of the fetus into the vaginal vault." Cytotec is also known to increase the risk of uterine rupture.

At around 3 p.m. on February 7, Shayla reported lower abdominal pain. She was again given Demerol. A Dr. Perper noted "SROM" (meaning that Shayla's water had broken) in her chart, and also noted that "a fetal part was protruding from the cervix into the vagina. But by 7 p.m., Shayla had still not expelled her fetus. Pendergraft ordered her moved to a procedure room.

Pendergraft examined Shayla and performed an ultrasound, showing the fetus in Shayla's uterus. The baby's leg was still protruding from the cervix, so Pendergraft used a Hearn forceps to pull off the leg. After he put the leg on a tray, Pendergraft consulted the ultrasound again, and it was discovered that her fetus was no longer in Shayla's uterus. Pendergraft concluded that Shayla's uterus had probably ruptured, which is a life threatening emergency. He consulted with doctors at Arnold Palmer Hospital to arrange for transport.

Neither in his note to be sent with Shayla to the hospital, nor in his phone conversations with the doctors there, did Pendergfaft tell anybody he had already removed a fetal leg. This resulted in prolonged surgery while doctors looked for the leg in Shayla's body, and performed an x-ray and CT scan to verify that it was not there. Pendergraft said he'd not documented or reported the removal of the fetal leg because he didn't think it would make any difference in the treatment Shayla would be given at the hospital.

Shayla remained hospitalized until at least February 10, at which point she was was still being treated for complications of the hysterectomy performed to save her life.

From what I can gather, it took this long to revoke Pendergraft's license due to legal wrangling between Pendergraft and the medical board.

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