"This case stems from the tragic and preventable death of Kalynda Lachelle Collins, a 32-year-old mother of two. Ms. Collins died as a direct result of the negligent, reckless and outrageous conduct of Defendants at the Cherry Hill Women's Center."
Thus opens the lawsuit filed by Kalynda's survivors against Cherry Hill Women's Center -- a name that has been linked to that malevolent phoenix, Steven Chase Brigham.
The Facility
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| Cherry Hill Women's Center |
From a surface examination, Kalynda had every reason to believe that she would receive the safest, highest-quality care at Cherry Hill Women's Center. But -- for reasons I'll go into later -- Kalynda had reasons of her own to question the quality of care she would get there. As I read through the lawsuit, I learned that this fatal abortion was the final time Cherry Hill Women's Center failed her, but was not the first.
Failures on Multiple Levels
When looking for information about this young black woman, I learned that she had not had an easy life.
Kalynda's Chaotic Family of Origin
Kalynda was born in 1985, daughter of Chris Anthony Ray Forrest Sr. It's doubtful that Kalynda had a stable childhood. Her father's obituary says that he left behind 12 children. Judging by their surnames, Chris Sr. had five babymammas and was living out of wedlock with the final one at the time of his death. Kalynda's mother, Lachelle, likely had the surname Collins when Kalynda and her siblings, Crystal and David, were born. Lachelle had evidently married between bearing children to Chris Forrest Sr. and her daughter's death, since she sued under the surname Ramsey.
His obituary indicates that he was a self-employed mechanic. He shows up in the newspapers for the first time I've found in 1973, when he was about 19 years old. He was ordered to pay $5 a week on a $15 fine and $10 in costs for having in his possession a driver's license and personal papers belonging to another man. He continues to show up for criminal activity:
- in 1974, at the age of 19, he was one of many people charged "during a wild melee." Five policemen were injured, one of whom was hospitalized with a head injury. The others arrested included Chris's sister, Barbara. The Millville Daily of July 24 said that "the disturbance .. apparently stemmed from a domestic quarrel."
- in 1976, at the age of 21, when a woman alleged that he kicked her and hit her with a bottle.
- in 1991, at the age of 36, he shows up in the Vineland, NJ Daily Journal because he was charged on multiple warrants, including "aggravated assault, conspiracy, creating a riotous condition, possession of a controlled dangerous substance (CDS), possession of a controlled dangerous substance with intent to distribute, domestic relations, and numerous motor vehicle violations."
- 2003, at the age of 48, he was wanted for failure to pay over $68,000 in child support.
- 2009 he got lengthy mention in the Daily Journal when he'd lied about his name to animal control officers regarding a loose pit bull, only to be positively identified. He was wanted on six contempt warrants in the area.
At 6:50 am, Kalynda was taken to an exam room for the pre-procedure screening. Defendant Ms. Batchelor recording her vital signs.
At 7:30 am, defendant Ms. Nunez reviewed consent forms and discharge instructions with Kalynda. The section of the consent forms regarding insertion of dilators notes that sometimes an allergic reaction to dilators can occur. The form did not indicate what specific dilators would be used, nor did it indicate that the dilators that would be used that day contained iodine.
As the lawsuit notes, "by inserting Laminaria sticks Defendant Dr. Lieblich virtually guaranteed that Ms. Collins would have an allergic or anaphylactic reaction." Such reactions to the iodine in laminaria are, the suit notes, "well documented in the medical literature." The suit goes on to say, "the physicians and staff of [Cherry Hill Women's Center] should have been well aware of the potential consequences of using this dilator in someone who is allergic to iodine."
Between 7:46 and 7:55 am, Kalynda was examined by Nurse Lake, who reviewed her medical and social history, allergies, and medications and examined her lungs and heart. Kalynda told Nurse Lake that she was allergic to iodine, as well as penicilling, adhesive tape, and latex. Nurse Lake recorded this in Kalynda's electronic chart.
Let's note here how far Kalynda got in this process before the abortion, which is supposed to be "a decision between her woman and her doctor," before she even saw a doctor. Only at this point does any discussion with a doctor begin.
Lieblich reviewed Kalynda's medical history and allergies, performed a physical examination, and determined that she was a good candidate for the one-day procedure.
At 9:09 am, less than four minutes after reviewing with Kalynda that she was allergic to iodine, Lieblich inserted 6 laminaria and two sterile sponges. He then administered misoprostol to Kalynda and instructed her to get dressed. Kalynda put her clothes back on and was taken to the "dress out" area where patients waited for the next step of their abortions.
At 9:25 am, Ms. Ortiz asked Nurse Cruz to check Kalynda out due to a rapid heart rate. Nurse Cruz noted that Kalynda's heart rate was 134, far higher than the normal resting heart rate of 60 to 100. Kalynda reminded Nurse Cruz that she was allergic to iodine.
Nurse Cruz notified Lieblich, and he ordered that she be brought to the post-anesthesia care unit (PACU) and be given Benadryl via IV to combat the allergic reaction. But before the Benadryl could be administered, Kalynda began to vomit and to perspire excessively.
Defendant Dr. Smith was summoned to see Kalynda. She was awake and responsive but also confused and disoriented. Her upper arm was in violent spasms. She was showing clear signs of anaphylactic shock.
For some reason, contrary to their transfer protocol with Kennedy University Hospital, Cherry Hill Women's Center staff did not contact EMS to transfer their gravely ill patient.
At 9:30, Dr. Lieblich was called back to check on Kalynda because her heart was racing and her blood pressure was dangerously low. He observed that Smith was assessing and tending to Kalynda. Nurse Rodgers administered Benadryl and Zofran by IV. Kalynda's heart rate was then recorded as 74, her blood pressure as 109/52. Kalynda was reporting itchy palms and nausea. Nurse Rodgers started IV fluids and oxygen by nasal cannula and placed Kalynda in the Trendelenburg position -- slanted with the head lower than the feet -- evidently in hope of increasing blood flow to Kalynda's brain. The lawsuit notes, "It appears that Nurse Rodgers was unaware of the widely circulated 2008 meta-study that found adverse consequences to the use of the Trendelenburg position and the recommendation that it be avoided."
Dr. Smith ordered a push of epinephrine via IV at 9:34.
Nurse Lake came to the PACU at 9:36 and found both doctors by Kalynda's side. Nurse Rodgers recorded Kalynda's blood pressure as having fallen to 98/48 and her pulse having risen to 122.
At 9:40, Kieblich removed the laminaria that had triggered the reaction at this point -- around fifteen minutes after Kalynda started showing signs of an allergic reaction.
Over the next few minutes, Smith administered more drugs to try to combat the anaphylaxis.
Finally, at 9:44 am -- 19 minutes after Kalynda started showing signs of anaphylaxis, and ten minutes after the first epinephrine was administered, staff finally initiated the transfer agreement and called 911.
While they waited for the ambulance to arrive, Cherry Hill Women's Center staff again took Kalynda's vitals. Dr. Smith and Nurse Lake intubated Kalyndra. Then, for some reason, Smith decided to administer 200 mg of Propofol. The lawsuit states, "Defendant Dr. Smith's decision to administer 200 mg of Propofol, which is the dose that would be used on a healthy patient, sealed [Kalynda's] fate and made her death a certainty. Propofol is a vasodilator [widens the blood vessels], accordingly it is not appropriate to use in patients who ... have low blood pressure." Kalynda's blood pressure was only 91/49 at the time the drug was administered. Three minutes later, Kalyndra was given succinylcholine, a muscle relaxant to make intubation and resuscitation easier. This enabled the doctor to complete the intubation at 9:51.
By then, Kalynda's pulse was 122 and her blood pressure 88/48.
Cherry Hill ambulance arrived just then to find Cherry Hill Women's Center providing artificial respiration with a bag-valve.
Now things get weird. The EMS patient record said that Kalynda started showing signs of anaphylaxis not after the insertion of the laminaria, but after administering a sedative. The doctor reportedly told EMS that Kalynda had quickly become unresponsive and they intubated her and called 911.
At 9:53 am, Kalynda's skin was cool, clammy, and pale. Her pulse was 162, her blood pressure 50/28, her respirations 12 (at the low end of the 12-20 normal rate), and her oxygen saturation was only 85%. EMS took over resuscitation. Advanced Life Support arrived at 10 am, found Kalynda to be in cardiac arrest, and started CPR.
At 10:05, Ms. Nunez called Kalynda's mother, Lachelle Ramsey, to say that her daughter was being transported to Kennedy Memorial Hospital in Cherry Hill. Kalynda arrived at 10:23, still with no pulse and with fixed pupils. Doctors attempted to revive her but pronounced her dead at 10:53, less than two hours after Dr. L inserted the dilators to which his patient had a predictable allergic reaction.
When the ER doctor called Smith, he blamed the allergic reaction on the misoprostol. Nobody told doctors at Kennedy Memorial about the six iodine-infused laminaria that had been placed in Kalynda's cervix.
What makes the use of laminaria particularly disturbing is that when Kalynda had gone to Cherry Hill Wome's Center in April of 2013, her chart noted that she'd had an allergic reaction to laminaria at that very facility in June of 2012 and that the doctor was to use Dilapans, a dilator that does not contain iodine.
