Dr. Alberto Hodari |
According to the Social Security Index, Regina Diane Johnson was a black woman born in Detroit.
A Falsified Signature Starts The Process
Nurse Cathy Litchtig performed an ultrasound, "even though there was no physician order for the study. She interpreted the study as showing a five week pregnancy and signed [Hodari's] name..." Dr. Milton Nathanson initialed the ultrasound to confirm Lichtig's finding.
CRNA Barry Thompson did the anesthesia while Nathanson did the abortion. Regina was given 200 mg of Diprivan, 2 mg Fentanyl, .2mg Gylcopyrrolate, and Droperidol to anesthetize her for the abortion, which was charted as taking place from 9:55 to 10:05 a.m.
Nurse Cathy Litchtig performed an ultrasound, "even though there was no physician order for the study. She interpreted the study as showing a five week pregnancy and signed [Hodari's] name..." Dr. Milton Nathanson initialed the ultrasound to confirm Lichtig's finding.
CRNA Barry Thompson did the anesthesia while Nathanson did the abortion. Regina was given 200 mg of Diprivan, 2 mg Fentanyl, .2mg Gylcopyrrolate, and Droperidol to anesthetize her for the abortion, which was charted as taking place from 9:55 to 10:05 a.m.
An Understaffed, Underequipped Recovery Room
Regina was then sent to the recovery room, along with five or six other patients under the care of Litchtig. Though clinic protocol required more than one staff person present when patients were in recovery, Lichtig was sometimes alone in caring for the patients.
Though Hodari's recovery room was equipped with a stethescope, oxygen bag/valve mask, and digital blood pressure cuff, it was not equipped with an EKG monitor, pulse oximeter, or automatic blood pressure/pulse monitor with alarm for monitoring patients, or with oxygen, a defibrillator, or other resuscitation equipment.
Lichtig recorded Regina's blood pressure and pulse manually upon admission to recovery, and at 10 - 15 minute intervals. At 10:05, Regina's blood pressure and pulse were a normal 116/72 and 82. At 10:15, they were 108/56 and 88. This fall in blood pressure and rise in pulse, especially in combination, are an early sign that a patient might be suffering complications such as blood loss. However, Lichtig reported that Regina's respiration was easy and unlabored.
The document notes that Lichtig was actually performing above the call of duty: Womancare protocol only required her to check a patient's vitals upon arrival in recovery, at 15 minues, and at discharge, usually after about an hour in recovery. Hodari's protocol also allowed for the nurse to discharge patients from the clinic. "There was no provision that the patient be seen by a physician once she was transferred to the recovery room."
Regina was then sent to the recovery room, along with five or six other patients under the care of Litchtig. Though clinic protocol required more than one staff person present when patients were in recovery, Lichtig was sometimes alone in caring for the patients.
Though Hodari's recovery room was equipped with a stethescope, oxygen bag/valve mask, and digital blood pressure cuff, it was not equipped with an EKG monitor, pulse oximeter, or automatic blood pressure/pulse monitor with alarm for monitoring patients, or with oxygen, a defibrillator, or other resuscitation equipment.
Lichtig recorded Regina's blood pressure and pulse manually upon admission to recovery, and at 10 - 15 minute intervals. At 10:05, Regina's blood pressure and pulse were a normal 116/72 and 82. At 10:15, they were 108/56 and 88. This fall in blood pressure and rise in pulse, especially in combination, are an early sign that a patient might be suffering complications such as blood loss. However, Lichtig reported that Regina's respiration was easy and unlabored.
The document notes that Lichtig was actually performing above the call of duty: Womancare protocol only required her to check a patient's vitals upon arrival in recovery, at 15 minues, and at discharge, usually after about an hour in recovery. Hodari's protocol also allowed for the nurse to discharge patients from the clinic. "There was no provision that the patient be seen by a physician once she was transferred to the recovery room."
Delay in Calling EMS
At 10:30, Lichtig was unable to rouse Regina, who still had a pulse and unlabored breathing. Lichtig tried for about ten minutes to awaken Regina. At about 10:40, she could no longer detect a pulse. She immediately told CRNA Thompson, who was then wheeling another patient into recovery. The two of them brought Regina back to the OR and began performing CPR. However, nobody called 911 until 11:00, twenty minutes after noting that Regina was pulseless. EMS arrived promptly, at 11:05.
EMS took Regina to Providence Hospital, where with continued CPR and got a pulse. Regina was put on life support, but was pronounced brain dead. She was taken off life support and declared dead on September 18. An autopsy determined that Regina had died from anoxic encephalopathy due to cardiac arrest. In other words, she died because her brain had been deprived of oxygen.
At 10:30, Lichtig was unable to rouse Regina, who still had a pulse and unlabored breathing. Lichtig tried for about ten minutes to awaken Regina. At about 10:40, she could no longer detect a pulse. She immediately told CRNA Thompson, who was then wheeling another patient into recovery. The two of them brought Regina back to the OR and began performing CPR. However, nobody called 911 until 11:00, twenty minutes after noting that Regina was pulseless. EMS arrived promptly, at 11:05.
EMS took Regina to Providence Hospital, where with continued CPR and got a pulse. Regina was put on life support, but was pronounced brain dead. She was taken off life support and declared dead on September 18. An autopsy determined that Regina had died from anoxic encephalopathy due to cardiac arrest. In other words, she died because her brain had been deprived of oxygen.
The Findings
The Administrative Complaint found Hodari to be negligent, incompetent, and lacking in good moral character. Hodari did not contest the findings, instead cooperating with bringing his facility up to standards to pass an inspection by an anesthesiologist in February of 2009. But in the mean time, he'd performed the fatal abortions on Tamiia Russell and Chivon Williams in 2004.
The state Attorney General's office fined Hodari $10,000 on March 4, 2009, for his part in the death.
The latest National Abortion Federation update no longer lists Womancare as a member, though they were recently. They certainly were in 2004, when Chivon and Tamiia died, which is the oldest page of Michigan NAF members that I can find on the Internet Archive. Womancare was also still a member in 2007, the most recent update on the Internet Archive. I'd be very interested in having NAF Annual Reports so I could look up what years Hodari and his mills were members.
The Administrative Complaint found Hodari to be negligent, incompetent, and lacking in good moral character. Hodari did not contest the findings, instead cooperating with bringing his facility up to standards to pass an inspection by an anesthesiologist in February of 2009. But in the mean time, he'd performed the fatal abortions on Tamiia Russell and Chivon Williams in 2004.
The state Attorney General's office fined Hodari $10,000 on March 4, 2009, for his part in the death.
The latest National Abortion Federation update no longer lists Womancare as a member, though they were recently. They certainly were in 2004, when Chivon and Tamiia died, which is the oldest page of Michigan NAF members that I can find on the Internet Archive. Womancare was also still a member in 2007, the most recent update on the Internet Archive. I'd be very interested in having NAF Annual Reports so I could look up what years Hodari and his mills were members.
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