Over the last two years, at least 15 states have initiated investigations into abortion clinics and individual abortion providers for providing substandard patient care – poor care that, in some cases, has resulted in women’s deaths.[i] However, recent revelations that many of the nation’s abortion clinics are the true “back alleys” that abortion advocates warned us about are just the tip of the proverbial iceberg. Substandard patient care is a long-standing and all-too-common problem in the abortion industry.
Planned Parenthood, the nation’s largest abortion provider, likes to pretend that it is “above the fray,” repeatedly assuring Americans that it provides consistent, quality patient care. As with many of the abortion giant’s public assurances, this promise has proven empty for Tonya Reaves, Diana Lopez, Holly Patterson, and an unknown number of other American women.
Tonya Reaves: Victim of Botched Abortion at Planned Parenthood’s “Flagship” Chicago Clinic
On July 20, 2012, Tonya Reaves, a 24-year-old mother of a one-year old son, entered a Planned Parenthood clinic on Michigan Avenue in Chicago. She was 16-weeks pregnant and was scheduled for a second-trimester abortion. At 11 am, she underwent a dilation and evacuation (“D&E”) abortion, a procedure where the physician dismembers and removes the unborn child in pieces. D&E abortions are often performed in the second trimester and involve significantly more risk to the woman than earlier abortions.
While in recovery, Ms. Reaves suffered significant bleeding and, more than 5 hours after the abortion, she was finally rushed by ambulance to Northwestern Memorial Hospital. At Northwestern, doctors performed an ultrasound and discovered an incomplete abortion. They performed a second D&E procedure. Ms. Reaves continued to suffer pain and other complications. A second ultrasound was then performed and doctors learned that Ms. Reaves had suffered a “perforation.” She was taken into surgery where “an uncontrollable bleed” was discovered. An emergency hysterectomy was performed, but it was too late. Tonya Reaves died at 11:20 pm.[ii]
An autopsy report released in early September 2012 confirmed that Ms. Reaves:
- Suffered from an incomplete abortion. Pieces of placenta were still attached to the inside of her uterus even after the second D&E procedure performed at Northwestern;
- Had a 3/16 inch perforation in her uterus near impression marks that appeared to have been made by forceps, instruments typically used during a D&E abortion;
- Suffered an “extensive” perforation of her broad uterine ligament with the possible severing of her left uterine artery; and
- Had one to one-and-a-half liters of blood and blood clots inside her abdominal cavity. Ms. Reaves had bled about 30 percent of her total volume of blood into her abdomen following a botched abortion at the Michigan Avenue Planned Parenthood clinic.[iii]
Diana Lopez: Victim of Planned Parenthood Clinic’s Disregard for Patient Safety and Its Own Treatment Protocols
In a stunningly similar incident, on February 28, 2002, 25-year-old Diana Lopez was 19 weeks pregnant when she went to a Planned Parenthood clinic in Los Angeles for an abortion. Before the day was over, Ms. Lopez – just like Ms. Reaves – had bled to death from a botched abortion.
Ms. Lopez’s cervix was punctured during a D&E abortion and she began bleeding profusely. She was later taken to Women’s and Children’s Hospital at County-USC Medical Center, where an emergency hysterectomy was performed. Sadly, Ms. Lopez died at 2:45 pm.[iv]
Following an investigation into Ms. Lopez’s death, the California Department of Health Services cited Planned Parenthood for multiple violations including:
- Inadequately advising against a potentially dangerous second-trimester, D&E abortion. Ms. Lopez’s hemoglobin levels were below what the clinic’s standards required before a D&E abortion could be safely performed. Notably, low hemoglobin levels often lead to increased bleeding;
- Failing to institute a necessary change to its treatment protocol concerning the use of laminaria (used to expand the cervix during a D&E procedure);
- Failing to demonstrate that the clinic had undertaken a complete assessment of the competency and credentials of the physician who performed Ms. Lopez’s abortion;
- Administering Cytotec (i.e. misoprostol, a component of the abortion drug RU-486 regimen) to Ms. Lopez on the first day (February 27, 2002) of a two-day abortion procedure, when the clinic’s treatment protocols required that it be administered 90 minutes before the surgical portion of the procedure;
- Failing to inform the clinic’s governing body of Ms. Lopez’s death;
- Failing to notify the California Health Department of Ms. Lopez’s death within 24 hours as required by state law; and
- Keeping incomplete records describing the care provided to Ms. Lopez.[v]
Clearly, Ms. Lopez’s death was the avoidable result of the Planned Parenthood clinic’s refusal to comply with its own treatment protocols and the apparent inability – or perhaps unwillingness –of the Planned Parenthood Federation of America (PPFA) to adequately monitor affiliates and to ensure compliance with medically appropriate standards of patient care.
Holly Patterson: Victim of Planned Parenthood’s Refusal to Follow FDA Protocols
On September 10, 2003, 18-year-old Holly Patterson entered a Hayward, California Planned Parenthood clinic seeking a chemical abortion. She died seven days later, on September 17, from a severe bacterial infection caused by an incomplete abortion.[vi]
The RU-486 regimen that Ms. Patterson used involves the ingestion of two drugs: mifepristone (or “RU-486” as it is more commonly known) which blocks the ability of the developing unborn child to receive progesterone, essentially starving the child to death; and misoprostol, a prostaglandin that causes a woman to expel the dead unborn child. Misoprostol is needed because, when taken alone, mifepristone/RU-486 fails in one-third of cases.
When the FDA approved the RU-486 regimen in September 2000, it prescribed a specific protocol for its use. In pertinent part, the approved protocol provides that, on the first day, a woman is to orally ingest three, 200-milligram tablets of mifepristone/RU-486 at the medical facility. Two days later, on the third day of the regimen, the woman is to return to orally ingest two, 200-microgram tablets of misoprostol.
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However, this approved treatment protocol was blatantly ignored by Planned Parenthood. Instead, on the first day, Ms. Patterson was given 200 milligrams of mifepristone, instead of the 600 milligrams prescribed by the FDA. She was also instructed to insert 800 micrograms of misoprostol vaginally at home the next day, rather than to return on the third day of the regimen to orally ingest 400 micrograms of misoprostol.[vii]
Ms. Patterson followed Planned Parenthood’s instructions. On September 14, 2003, she was treated at an emergency room for bleeding and pain and sent home. Three days later, in the early morning hours of September 17, she was admitted to the hospital. She died that afternoon, the same day she was scheduled to return to Planned Parenthood to make sure the abortion had been completed.[viii] As Holly’s father, who was with her as the septic shock overtook her body and ultimately claimed her life, described, “It was a really horrible death for her.”[ix]
Sadly, Ms. Patterson is not alone in her suffering. In July 2011, the FDA reported 2,207 adverse events in the U.S. after women used the RU-486 regimen. Among those were 14 deaths, 612 hospitalizations, 339 blood transfusions, and 256 infections (including 48 “severe infections”).[x] Of the reported deaths, eight were from severe bacterial infections. All eight women administered misoprostol either vaginally or buccally (allowed to dissolve in the mouth) – i.e., in an off-label, unapproved manner. No women have died from bacterial infection following administration of the FDA-approved protocol.[xi]
In spite of mounting evidence of the RU-486 regimen’s dangers, especially the unacceptably high risk of infection and death associated with off-label use of the regimen, Planned Parenthood has not stopped using unapproved RU-486 treatment protocols. Instead, the abortion mega-provider continues to use protocols that deviate substantially from the FDA’s and to actively resist attempts by state lawmakers to force them to abide by the approved protocol. They have even gone so far as to eliminate the in-person involvement of a physician in the RU-486 regimen, championing a “telemed” abortion scheme (where consultation with a physician is only available over a telecommunications system such as Skype) for its clinics nationwide.
We know that Tonya Reaves, Diana Lopez, and Holly Patterson suffered and died at the hands of Planned Parenthood. What we don’t know is just how many women and their loved ones have suffered in silence following abortions at Planned Parenthood clinics. As AUL argued in its July 2011 report, The Case for Investigating Planned Parenthood, it is time to find out.
[i] Those states are Alabama, California, Delaware, Florida, Illinois, Kansas, Louisiana, Maryland, Massachusetts, Michigan, New Jersey, New Mexico, North Dakota, Pennsylvania, and Texas. For more information about substandard conditions at the nation’s abortion clinics, see D.M. Burke, “Exposing Substandard Abortion Facilities: The Pervasiveness of True ‘Back Alley’ Abortions,” Defending Life 2012, pp. 47-53 (Americans United for Life, 2012).
[ii] See, e.g., “Documents Shed Light on Women’s Death After Abortion,” available at http://chicago.cbslocal.com/2012/07/24/documents-shed-light-on-womans-death-after-abortion/ (last visited Sept. 11, 2012).
[iii] See “Autopsy Proves Planned Parenthood Killed Woman in Botched Abortion,” available at http://www.lifenews.com/2012/09/11/autopsy-proves-planned-parenthood-killed-woman-in-botched-abortion/ (last visited Sept. 11, 2012).
[iv] See “Clinic, Doctor Faulted in Abortion Death,” available at http://articles.latimes.com/2003/jun/25/local/me-abortion25 (last visited Sept. 11, 2012).
[v]Id.; see also, “Abortionist Involved in Woman’s Death Awaits Word on Medical License,” available at http://cnsnews.com/news/article/abortionist-involved-womans-death-awaits-word-medical-license (last visited Sept. 11, 2012).
[vi] See “Monty Patterson learns about RU-486 the hard way,” available at http://www.sfgate.com/entertainment/article/Monty-Patterson-learns-about-RU-486-the-hard-way-2345757.php (last visited Sept. 12, 2012).
[viii] See “Teen Death Steers RU-486 Bill To Congress, available at http://womensenews.org/story/reproductive-health/041115/teen-death-steers-ru-486-bill-congress (last visited Sept. 12, 2012).
[x] FDA, Mifepristone U.S. Postmarketing Adverse Events Summary Through 04/30/11 (July 2011), available at http://www.fda.gov/downloads/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/UCM263353.pdf (last visited July 11, 2012).
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