February 20: The Deliberate Overdose

Deliberate Overdose Kills Patient

When 23-year-old Stacy Ruckman had just gotten a new job when she went to Scott Barrett for a safe and legal abortion on February 20, 1988. Unfortunately, she didn't know how he anesthetized his patients at his unlicensed clinic: Central Health Center for Women in Springfield, Missouri.

Barrett began the 13-14 week abortion at around 5 p.m. During the abortion, Stacy stopped breathing, Barrett and his staff were unable to revive her. 

Another source had Stacy on the table for half an hour without mishap, but collapsing when she got off the table at 6 p.m. This story is less than credible, since abortions don't usually taken an entire hour.

Staff called an ambulance, but the medics found Stacy in full cradio-respiratory arrest, with unresponsive pupils. The resuscitation attempts made by paramedics included suctioning "copious amounts of blood" from Stacy's airway, inserting an endotracheal tube, administering medications and oxygen, putting in an IV, and using a defibrillator.

They transferred Stacy to the emergency room, where she had a racing pulse and fixed, dilated pupils. She was unable to breathe on her own. The hospital transfused her with packed red blood cells and gave her additional IV fluids, but her EEG "revealed findings consistent with brain death" 

Stacy's parents, who hadn't even known she'd been pregnant, rushed to the hospital to find that they daughter they'd loved so well was gone. They agreed with the doctors to remove life support, and Stacy was pronounced dead at 11:34 p.m.

That night when we walked out of the hospital I just felt like I left part of me in there. Part of me was dead,'' Stacy's mother Judith said. You carry a child for nine months and something like that happens, you feel like you lost part of yourself, part of your body. And you're never going to get it back.''

Scott Barrett's clinic

Stacy's father requested an autopsy, which found toxic concentrations of Lidocaine in Stacy's blood. Her serum level, as tested in blood drawn 2 hour after the abortion, was 8.1 ug/ml, or more than five times the therapeutic level of 1.5 ug/ml. An expert who testified later estimated that, based on how fast the body metabolizes Lidocaine, the amount in her system at the time of the abortion could have been as high as 16 ug/ml, over ten times the therapeutic dose.

In order to rule out other causes of death, the coroner examined ten times the normal number of specimens, looking for signs of an amniotic fluid embolism. He could find no such evidence. He also found no evidence of "any naturally occurring disease process which could account for Ms. Ruckman's death." What he did find was "history of a grand mal seizure and cardiac arrest after a 'therapeutic' abortion at 13.8 weeks gestation." Stacy also had suffered cerebral and pulmonary edema (swelling of the brain and lungs), pulmonary hemorrhage (excessive bleeding in the lungs), clotted and unclotted blood in her mouth and nose, around 55 cc of bloody fluid surrounding her lungs, and another 200 cc's of bloody fluid in her pelvic cavity.

Stacy's parents sued. An anesthesiologist was asked under oath to give any and all possible medically valid reasons for administering that high a dose of Lidocaine; he repeatedly answered that he could think of none. The only reason he could think of -- not a medically valid one -- was to speed up the abortion. Barrett's nurse testified that he typically did 35-40 abortions per day, at $300 each.

Dr. Scott Barrett

She, and other staff, also testified that Barrett routinely gave patients massive dosed of Lidocaine in order to render them unconscious.

The court found that Barrett altered or falsified Stacy's records in attempt to cover his culpability. The Medical board likewise implicated Barrett in Stacy's death. They also found fault with him regarding other matters:

• Barrett perforated the uterus of patient S.G., causing hemorrhage. He was inadequately prepared to treat her and delayed transfer to a hospital.
• Barret performed an incomplete abortion on patient S.C., causing an infection.
• Barrett lacked hospital admitting privileges.
• Barrett routinely administered lidocaine improperly and without means available to treat any adverse reactions.
• Barrett pre-signed prescription forms for controlled substances and left them around his office where staff would have access to them.

A jury awarded Stacy's parents $25.3 million for the wrongful death of their daughter -- $330,000 in actual damages, and $25 million in aggravated damages. However, Barrett carried no insurance and was not represented at all during the trial; he himself failed to show up. He had insisted to the media that the case was only being pursued as a way of putting abortion clinics out of business.

In spite of the medical board investigation and the fact that the clinic was unlicensed, Barrett continued to perform up to 40 abortions a day.  The Springfield News Leader also noted that local hospitals were failing to report to the authorities when they were treating Barrett's patients for complications. He also continued to perform abortions in the suburban St. Louis clinic he operated in partnership with Dr. Bolivar Escobedo. 

The paper also noted that Barrett had left one woman saddled with $3,000 in medical bills to treat an incomplete abortion he had performed on her, and had sliced another woman's uterus in half during an abortion. Doctors who spoke to the Springfield Leader expressed frustration with the state's failure to shut Barrett down, saying that they were tired of dealing with patients whose abortions he'd botched and then left without any arrangements for aftercare. One doctor said he'd treated a woman who had bled for two months following an abortion by Barrett but when she would call the clinic they'd tell her the bleeding was normal.

Stacy's mother, Judith, told the paper that at least ten people had spoken to her after the malpractice case, telling of their own experiences. One stopped her in a grocery store to talk. Three years after Stacy's death her parents were still fighting to get Barrett's license revoked.

Watch Fatal Shortcut on YouTube.

• "Doctor negligent in three abortions, state panel says," Springfield News-Leader, March 7, 1990
• "Physician's work stretches across state," Springfield News Leader, June 9, 1991
• "Death, state inquiry shadow physician's practice," Springfield News-Leader, June 9, 1991
• "Doctor's abortions scar patients, peers," Springfield News-Leader, June 9, 1991
• "Delays, legal entanglements hold up licensing complaint," Springfield News-Leader, June 9, 1991