By Marie McCullough
Inquirer Staff Writer
The arrest of West Philadelphia abortion doctor Kermit Gosnell on charges of murdering a patient and seven newborn infants has thrown an unusual spotlight on Pennsylvania regulators who, a Philadelphia grand jury concluded, "should have shut him down long ago."
But Pennsylvania's system of oversight - or lack of it, in the grand jury's view - may not be unusual.
For five months last year, New Jersey regulators received complaints that abortion doctor Steven Brigham, 54, was running a secret, cash-only, late-term abortion business using a risky interstate scheme - one for which he was disciplined in the 1990s.
Just as in the Gosnell case, regulators took no public action against Brigham - until a police raid forced them to.
New Jersey officials declined to comment for this article, as did the law firm representing Brigham.
Prosecutors, public health experts, and others say these cases illustrate a host of problems, including a feeble complaint system, spotty clinic inspections, poor communication among oversight agencies - and the reluctance of doctors to punish their own.
"In general, the discipline of doctors in this country is a disaster," said physician Sidney Wolfe, director of health research for Public Citizen, a consumer-advocacy group.
In Public Citizen's annual look at rates of serious disciplinary actions by state medical boards, New Jersey and Pennsylvania rank among the least aggressive, having acted against fewer than three in every 1,000 physicians between 2007 and 2009.
Beyond patient safety, abortion regulation is tangled in moral, political, and commercial issues.
Consider that Brigham's latest travails - license suspension in New Jersey and a criminal probe in Maryland - have not halted his abortion enterprise, called American Women's Services. The toll-free phone lines are taking calls for its clinics in New Jersey, Pennsylvania, Maryland, Virginia - and a recent addition, Pensacola, Fla.
"Businesses aren't regulated that well, but they should be, especially businesses that affect the public health and well-being," said Leonard Glantz, a health law professor at Boston University.
More dangerous
Abortion goes from being brief and low-risk for the mother during the first three months, when the fetus is tiny, to being increasingly dangerous as the fetus grows.
At about 15 weeks - long before the full-term point of 38 weeks - abortion is a protracted process. The first day, the fetal heart is given a lethal injection, and the woman's cervix is slowly dilated using absorbent rods. The next day, the woman receives labor-inducing drugs, then undergoes surgery to remove the fetus, intact or in pieces.
Recognizing the incremental complexity, the New Jersey Department of Health and Senior Services has a two-tiered system. Abortions through 14 weeks can be done in the equivalent of a doctor's office, no license necessary. Beyond 14 weeks, the facility must be licensed as an outpatient surgical center, complete with an ambulance service, biennial inspections, and a highly trained doctor.
None of Brigham's six New Jersey clinics is licensed to do surgery, so, rather than lose business, he evaded the rules, prosecutors say. He initiated late-term abortions in Voorhees; the next day, he led car caravans of patients, in labor, to Elkton, Md., for surgery.
In Pennsylvania, the jury found, outpatient-surgery centers are covered by 50 pages of safety rules, including regular inspections. However, regulators have chosen to interpret the law as not applying to abortion facilities.
Regulators, the jury report says, "have tied their own hands and now complain that they are powerless."
A year ago, after the raid that revealed awful conditions at Gosnell's clinic, Gov. Ed Rendell ordered a resumption of annual inspections, which had not been done for 15 years. Of the state's 20 freestanding clinics, 14 have been ordered to fix problems, none egregious.
Viable fetus
Pennsylvania - like 40 other states, but not New Jersey - outlaws abortion after 24 weeks, the point when the fetus usually becomes "viable," able to survive outside the womb. The U.S. Supreme Court ruled that abortion of a viable fetus may be banned unless it is necessary to save the woman's life or health.
Understandably, there is confusion about what is and isn't legal. Gosnell's patients testified that they did not realize their post-viability abortions were prohibited.
They also testified that because they were anesthetized, they didn't know he delivered their fetuses alive, then killed them by severing their spinal cords with scissors.
Why this gruesome deviation from the standard practice of giving the fetus a lethal injection in the womb?
Gosnell's employees said that he tried giving injections, but that his shots missed the target, so he gave up.
Relying on complaints
Regulators say that to protect the public, they rely on complaints from patients, employees, even reporters.
"We're all pretty much complaint-driven" in the United States, said William L. Harp, executive director of the Virginia Board of Medicine. "When a complaint comes in, then we have ability to investigate."
In Brigham's case, just as in Gosnell's, complaints were not enough.
Elizabeth Barnes, director of Cherry Hill Women's Center, a South Jersey abortion clinic, said she wrote to New Jersey's medical licensing board in June 2009 detailing her suspicions that Brigham was starting third-trimester abortions in Voorhees and finishing them in a clandestine clinic, probably in Maryland.
In response, Barnes said, an investigator talked to her, off and on, for months. Yet no official action was taken against Brigham.
Barnes' suspicions should have rung bells. In the 1990s, Brigham did late-term abortions that straddled Voorhees and New York City.
In 1994, New York authorities took his license in that state for botching two abortions, one begun in Voorhees. They called him "undertrained," with "submarginal abilities" and "not the slightest recognition of his deficiencies." New Jersey prosecuted Brigham for those same cases, plus four more. But Brigham's appeals ultimately reached an administrative judge who found him "sincere" and "credible," and reinstated his license.
Brigham's latest contrivance became news in August after a New Jersey woman, 18, went to Elkton police.
She told them of her unexpected Aug. 13 odyssey from Voorhees to Elkton, of an abortion that left her so critically injured that she had to be airlifted to a Baltimore hospital for emergency surgery.
On Aug. 17, police raided the Elkton clinic - a storefront operation with no sign, that had opened about a year earlier - but could not find her medical records. They did, however, find 35 late-term fetal bodies and parts, none with records.
New Jersey subsequently suspended Brigham's license pending a revocation hearing in April. In Maryland, where he has never been licensed, authorities say a criminal investigation into possible felony charges is ongoing.
Abortion businesses
In most states, a doctor who is barred from performing abortions can still have an abortion business.
Brigham is an example. Although Elkton is closed, three American Women's Services clinics are open in Maryland. So are six in New Jersey, two in Virginia (where he has never had a license), and two in Pennsylvania.
People on both sides of the abortion debate say this shows the need for better interdepartmental and interstate communication, as well as ways to flag dubious corporate practices.
Jennifer Boulanger, executive director of the Allentown Women's Center, who has helped patients and others file complaints about care at American Women's Services clinics, said, "If a person owns lots of corporations at the same address for the same business, that should be a red flag for possible deceptive practices that warrant further investigation."
Corporate records connect Brigham to dozens of entities, including the Caring Corp. and the Peaceful Corp. Many use the Voorhees address, 1 Alpha Ave.
Last March, a new company that uses the Voorhees mailing address opened an abortion clinic in Pensacola, Fla., records show. The owner of the building is another new company that lists Brigham's wife, Krishni Dethabrew, as an authorized representative.
Florida revoked Brigham's license in 1995 after learning of New York's action.
"There is nothing in Florida law that would prevent Dr. Brigham from having part ownership in these entities," e-mailed Shelisha Durden, spokeswoman for the agency that oversees health facilities. "Unless there are specific allegations (such as practicing medicine in Florida without a license), there is nothing for the agency to investigate."
The Pennsylvania Health Department tried to get tough after repeatedly sanctioning Brigham for employing unlicensed caregivers.
In July, the department ordered him not to have an "equity interest" in abortion clinics or to "directly or indirectly" register any in the state. (He is appealing the order.)
But then the department proceeded to approve the new owner of his Allentown and Pittsburgh facilities: a new company headed by his mother, Judith Fitch, 71, of Toledo, Ohio. She hung up twice when called for comment.
Does the family tie defy the order?
Spokeswoman Holli Senior checked with agency lawyers, then e-mailed: "The department's decision does not apply" to Fitch's company.
Friday, July 8, 2011
Md. weighs abortion restriction
By BEN NUCKOLS • Associated Press • January 16, 2011
BALTIMORE — Maryland lawmakers will consider
legislation to ban the sort of interstate abortions
performed last year by a Voorhees doctor whose
license has since been suspended.
Dr. Steven Brigham operated an abortion clinic in
Elkton. New Jersey regulators suspended his license
after finding that he was starting late-term abortions
at his Voorhees clinic, then ferrying patients to
Maryland to complete the procedures in an apparent
bid to skirt New Jersey's more restrictive abortion
laws.
Delegate Michael Smigiel, R-Cecil, has introduced
three bills intended to prevent anything similar from
happening in the future. One would mandate that an
abortion begun in Maryland must be concluded in
the state except during an emergency.
Smigiel's law office is half a block away from
Brigham's clinic, and he said he was shocked to
learn what was going on there.
Brigham's practices first caught the attention of
Maryland regulators after a patient was hospitalized
with a ruptured uterus and small intestine. Brigham
was ordered to stop practicing without a license in
the state.
Smigiel's other bills would require that abortions be
reported to the Department of Health and Mental
Hygiene and mandate that patients who suffer
complications be transported by ambulance.
Another bill, sponsored by Delegates Adelaide
Eckardt, R-Dorchester, and Pamela Beidle, D-Anne
Arundel, would reclassify abortion clinics as free-
standing surgical facilities, subjecting them to
increased regulation. Current Maryland law allows
for abortions to be performed at ordinary doctor's
offices.
BALTIMORE — Maryland lawmakers will consider
legislation to ban the sort of interstate abortions
performed last year by a Voorhees doctor whose
license has since been suspended.
Dr. Steven Brigham operated an abortion clinic in
Elkton. New Jersey regulators suspended his license
after finding that he was starting late-term abortions
at his Voorhees clinic, then ferrying patients to
Maryland to complete the procedures in an apparent
bid to skirt New Jersey's more restrictive abortion
laws.
Delegate Michael Smigiel, R-Cecil, has introduced
three bills intended to prevent anything similar from
happening in the future. One would mandate that an
abortion begun in Maryland must be concluded in
the state except during an emergency.
Smigiel's law office is half a block away from
Brigham's clinic, and he said he was shocked to
learn what was going on there.
Brigham's practices first caught the attention of
Maryland regulators after a patient was hospitalized
with a ruptured uterus and small intestine. Brigham
was ordered to stop practicing without a license in
the state.
Smigiel's other bills would require that abortions be
reported to the Department of Health and Mental
Hygiene and mandate that patients who suffer
complications be transported by ambulance.
Another bill, sponsored by Delegates Adelaide
Eckardt, R-Dorchester, and Pamela Beidle, D-Anne
Arundel, would reclassify abortion clinics as free-
standing surgical facilities, subjecting them to
increased regulation. Current Maryland law allows
for abortions to be performed at ordinary doctor's
offices.
Abortion doctor's license temporarily suspended
By JIM WALSH • Courier-Post Staff • October 14, 2010
TRENTON — State regulators on Wednesday night
temporarily suspended the medical license of a
Voorhees abortion doctor.
The Board of Medical Examiners in its decision
called Dr. Steven Brigham a "clear and imminent
danger to the public's health, safety and welfare,"
according to an account from the state Attorney
General's Office.
Brigham's attorney, Joseph Gorrell, could not be
reached for comment.
The case now is to go before an administrative law
judge, who will hear arguments and review
evidence. The board will review the judge's initial
decision before making a final ruling, said Paul
Loriquet, a spokesman for the Attorney General's
Office.
The Attorney General's Office contends Brigham
improperly performed late-term abortions at his
Voorhees clinic. State rules limit abortions there to
women who are no more than 14 weeks pregnant.
Authorities said Brigham terminated pregnancies as
far along as 33 weeks by starting the procedure in
Voorhees. His patients then would travel a day or
two later to complete the process in Elkton, Md.
Brigham, who has run the American Women's Center
on Alpha Avenue since 1992, denied any
wrongdoing. He argued the abortion did not occur
until the fetus was removed in Maryland, and so
New Jersey's rules were not broken.
Officials moved against Brigham after one of his
patients, an 18-year-old woman, needed emergency
surgery in Maryland. A doctor working for Brigham
perforated the woman's uterus during an abortion
attempt in August, officials said.
The woman was one of five patients, each more than
14 weeks pregnant, cited by authorities in the case
against Brigham.
Brigham had a similar dispute with the state in
1996. Brigham prevailed at that time, Gorrell said.
TRENTON — State regulators on Wednesday night
temporarily suspended the medical license of a
Voorhees abortion doctor.
The Board of Medical Examiners in its decision
called Dr. Steven Brigham a "clear and imminent
danger to the public's health, safety and welfare,"
according to an account from the state Attorney
General's Office.
Brigham's attorney, Joseph Gorrell, could not be
reached for comment.
The case now is to go before an administrative law
judge, who will hear arguments and review
evidence. The board will review the judge's initial
decision before making a final ruling, said Paul
Loriquet, a spokesman for the Attorney General's
Office.
The Attorney General's Office contends Brigham
improperly performed late-term abortions at his
Voorhees clinic. State rules limit abortions there to
women who are no more than 14 weeks pregnant.
Authorities said Brigham terminated pregnancies as
far along as 33 weeks by starting the procedure in
Voorhees. His patients then would travel a day or
two later to complete the process in Elkton, Md.
Brigham, who has run the American Women's Center
on Alpha Avenue since 1992, denied any
wrongdoing. He argued the abortion did not occur
until the fetus was removed in Maryland, and so
New Jersey's rules were not broken.
Officials moved against Brigham after one of his
patients, an 18-year-old woman, needed emergency
surgery in Maryland. A doctor working for Brigham
perforated the woman's uterus during an abortion
attempt in August, officials said.
The woman was one of five patients, each more than
14 weeks pregnant, cited by authorities in the case
against Brigham.
Brigham had a similar dispute with the state in
1996. Brigham prevailed at that time, Gorrell said.
Abortion doctor says New Jersey, Maryland can't discipline him
By Marie McCullough
Posted on Sat, Oct. 9, 2010
Inquirer Staff Writer
Abortion doctor Steven Brigham, who has been accused of negligence and misconduct for starting late-term abortions in New Jersey and completing the procedures in Maryland, contends the two states have no grounds to discipline him.
In legal papers filed Thursday with New Jersey regulators, Brigham says the state can't punish him now because he's doing the same thing he did when it prosecuted, and exonerated, him in the mid-1990s.
"Ludicrous," New Jersey Deputy Attorney General Jeri Warhaftig, who is leading the current prosecution, said in a legal response. The previous ruling "did not relieve [Brigham] of the burden of exercising good medical judgment or the obligation to play by the rules."
In Maryland, Brigham has been charged with practicing medicine without a license. He filed legal papers there contending that he didn't need a license because he was simply "engaging in consultation."
He asked the Maryland Board of Physicians to dismiss his case and allow him "to continue providing demonstrations, training, and assistance to Maryland doctors who seek his expertise and guidance."
The board had no comment on Friday.
Brigham, 54, owns a Voorhees-based chain of abortion clinics called American Women's Services. It operates in New Jersey, Maryland, and Virginia, and, until earlier this year, was in Pennsylvania.
He transferred his four Pennsylvania facilities to a newly created company headed by a close relative, and is appealing that state's revocation of his ownership rights for persistently employing unlicensed caregivers.
Brigham has spent much of his 20-year career fighting lawsuits and disciplinary actions. The latest investigations - which authorities say could result in criminal as well as regulatory charges - were launched after one of the bistate abortions went awry in August.
The patient, an 18-year-old New Jersey woman who was 21 weeks pregnant, suffered a punctured uterus and bowel at Brigham's Elkton, Md., clinic. She had to be airlifted to a Baltimore hospital for emergency surgery to repair her uterus and bowel. She and the surgeon subsequently filed complaints against Brigham, according to medical records and documents released by investigators.
Investigators allege that Brigham exploited the complex process of late-term abortion at the expense of patients' safety: in Voorhees, he allegedly inserted absorbent rods called laminaria to widen patients' cervixes over 24 hours or more, and gave their fetuses lethal injections. The next day, he allegedly gave the patients a drug to induce labor, then led them in an hour-long car caravan to Elkton for extraction of their dead fetuses.
One patient, documents show, didn't make it to Elkton. She began having severe abdominal pains at night in her hotel and was rushed to Virtua Hospital in Voorhees, where she delivered a dead fetus.
Prosecutors say Brigham's scheme was intended to evade New Jersey safety rules. None of Brigham's six New Jersey clinics is permitted to do abortions after 14 weeks because they do not meet outpatient surgery requirements.
In his legal papers, Brigham argues that the question of whether he may legally insert laminaria in Voorhees was decided by New Jersey regulators in 1996 - in his favor. (New York, however, revoked his medical license there for "gross incompetence" in performing late-term abortions, two of which were initiated in Voorhees.)
"The repeated investigation and harassment by [the attorney general], even after [Brigham] was exonerated by the New Jersey State Board of Medical Examiners in 1996 for the very same alleged wrongdoings that are now claimed again, raises real questions as to the good faith" of the allegations, his legal papers say.
Warhaftig, in her response, said the 1996 decision did not address his current conduct, which allegedly includes killing fetuses and giving the labor-inducing drug in Voorhees.
"If anything, those earlier actions drew a line in the sand," she wrote. Brigham "has stepped over, far over, the board's line and his conduct poses a clear and imminent danger to the public."
Warhaftig also cited records and testimony that undercut Brigham's contention that he was just "consulting" in Maryland: the completion of an abortion for a woman who was almost eight months pregnant happened on a day when a young physician Brigham was training "was not present in the clinic."
Brigham, whose New Jersey license has been temporarily suspended, has a hearing Wednesday before the New Jersey Board of Medical Examiners. The board will consider his argument that it cannot prosecute him. It will also consider the attorney general's request to strip his license for good.
Posted on Sat, Oct. 9, 2010
Inquirer Staff Writer
Abortion doctor Steven Brigham, who has been accused of negligence and misconduct for starting late-term abortions in New Jersey and completing the procedures in Maryland, contends the two states have no grounds to discipline him.
In legal papers filed Thursday with New Jersey regulators, Brigham says the state can't punish him now because he's doing the same thing he did when it prosecuted, and exonerated, him in the mid-1990s.
"Ludicrous," New Jersey Deputy Attorney General Jeri Warhaftig, who is leading the current prosecution, said in a legal response. The previous ruling "did not relieve [Brigham] of the burden of exercising good medical judgment or the obligation to play by the rules."
In Maryland, Brigham has been charged with practicing medicine without a license. He filed legal papers there contending that he didn't need a license because he was simply "engaging in consultation."
He asked the Maryland Board of Physicians to dismiss his case and allow him "to continue providing demonstrations, training, and assistance to Maryland doctors who seek his expertise and guidance."
The board had no comment on Friday.
Brigham, 54, owns a Voorhees-based chain of abortion clinics called American Women's Services. It operates in New Jersey, Maryland, and Virginia, and, until earlier this year, was in Pennsylvania.
He transferred his four Pennsylvania facilities to a newly created company headed by a close relative, and is appealing that state's revocation of his ownership rights for persistently employing unlicensed caregivers.
Brigham has spent much of his 20-year career fighting lawsuits and disciplinary actions. The latest investigations - which authorities say could result in criminal as well as regulatory charges - were launched after one of the bistate abortions went awry in August.
The patient, an 18-year-old New Jersey woman who was 21 weeks pregnant, suffered a punctured uterus and bowel at Brigham's Elkton, Md., clinic. She had to be airlifted to a Baltimore hospital for emergency surgery to repair her uterus and bowel. She and the surgeon subsequently filed complaints against Brigham, according to medical records and documents released by investigators.
Investigators allege that Brigham exploited the complex process of late-term abortion at the expense of patients' safety: in Voorhees, he allegedly inserted absorbent rods called laminaria to widen patients' cervixes over 24 hours or more, and gave their fetuses lethal injections. The next day, he allegedly gave the patients a drug to induce labor, then led them in an hour-long car caravan to Elkton for extraction of their dead fetuses.
One patient, documents show, didn't make it to Elkton. She began having severe abdominal pains at night in her hotel and was rushed to Virtua Hospital in Voorhees, where she delivered a dead fetus.
Prosecutors say Brigham's scheme was intended to evade New Jersey safety rules. None of Brigham's six New Jersey clinics is permitted to do abortions after 14 weeks because they do not meet outpatient surgery requirements.
In his legal papers, Brigham argues that the question of whether he may legally insert laminaria in Voorhees was decided by New Jersey regulators in 1996 - in his favor. (New York, however, revoked his medical license there for "gross incompetence" in performing late-term abortions, two of which were initiated in Voorhees.)
"The repeated investigation and harassment by [the attorney general], even after [Brigham] was exonerated by the New Jersey State Board of Medical Examiners in 1996 for the very same alleged wrongdoings that are now claimed again, raises real questions as to the good faith" of the allegations, his legal papers say.
Warhaftig, in her response, said the 1996 decision did not address his current conduct, which allegedly includes killing fetuses and giving the labor-inducing drug in Voorhees.
"If anything, those earlier actions drew a line in the sand," she wrote. Brigham "has stepped over, far over, the board's line and his conduct poses a clear and imminent danger to the public."
Warhaftig also cited records and testimony that undercut Brigham's contention that he was just "consulting" in Maryland: the completion of an abortion for a woman who was almost eight months pregnant happened on a day when a young physician Brigham was training "was not present in the clinic."
Brigham, whose New Jersey license has been temporarily suspended, has a hearing Wednesday before the New Jersey Board of Medical Examiners. The board will consider his argument that it cannot prosecute him. It will also consider the attorney general's request to strip his license for good.
Brigham behind secretive late-term abortion clinic
By Marie McCullough
Posted on Tue, Sep. 21, 2010
Inquirer Staff Writer
For more than a year online, "Grace Medical Care" has advertised abortions up to the last few weeks of pregnancy. It said it's located in a Philadelphia suburb, yet kept the address secret. And it has operated without the knowledge of state regulatory authorities.
Now, for the first time, the New Jersey Attorney General's Office says the person behind the clandestine enterprise is Steven Chase Brigham, the physician being investigated by New Jersey and Maryland on suspicion of licensing and criminal offenses.
Brigham's attorney, Joseph Gorrell of Roseland, N.J., did not return a call or e-mail requesting comment.
Brigham, 54, who has been in and out of trouble for much of his two-decade career, operates at least a dozen abortion clinics in New Jersey, Pennsylvania, Maryland, and Virginia under the name American Women's Services.
He has many other "entities," including Grace Medical Care, also called Grace Medical Services, say the attorney general's Sept. 8 charges.
Variations of Grace Medical turn up repeatedly in late-term abortion records recently seized from Brigham's offices.
Authorities said he initiated those abortions in the Voorhees headquarters of American Women's Services, then finished them the next day in Elkton, Md. - a scheme authorities say was designed to evade outpatient-surgery rules.
New Jersey is also looking into why state agencies that oversee businesses and medical facilities have no records for Grace Medical, said the attorney general's spokesman, Paul Loriquet.
Grace Medical remained a mystery even to doctors recruited by Brigham over the last year to work in Elkton, transcripts of interviews with investigators show.
Kimberly Walker, a young doctor who began training with Brigham in January, told investigators: "He basically calls the later-[term] cases, he calls them Grace patients. I don't know what Grace means."
George Shepard, an 88-year-old Delaware gynecologist hired as medical director at Elkton, was asked by investigators whether the Elkton facility was called "Grace something."
"I've heard the word Grace, but I'm not sure that they call it that," he responded. "All I know is Elkton."
The latest inquiry was launched after one of Brigham's bistate abortions went awry. An 18-year-old New Jersey woman who was 21 weeks pregnant suffered life-threatening complications Aug. 13 and had to be airlifted from Elkton to Johns Hopkins Hospital in Baltimore. She and a Hopkins physician later filed complaints.
Investigators soon discovered that Brigham has never had a medical license in Maryland. They also seized 35 frozen fetuses and fetal parts from Elkton, but they could not find medical records for 33 of those abortions either in Elkton or Voorhees.
Brigham has a hearing scheduled for Oct. 13 before the New Jersey Board of Medical Examiners to say why he should not lose his medical license there, the only state where he still has one. Pennsylvania, New York, and Florida took away his practice privileges in the 1990s.
Although Grace Medical Services was a regulatory phantom, it caught the attention of other abortion providers last summer. They were startled because its online ad explicitly offered "abortions up to 36 weeks" - two weeks shy of a full-term delivery - a risky procedure most doctors are loath to perform. The website said payments had to be in cash, while practically all providers accept health insurance. And not only was no address listed, but Grace Medical's phone receptionist would not readily divulge it.
Even in this era of heightened security amid fears of antiabortion violence, the secrecy seemed intended to hide the clinic, not protect it, said Vicki Saporta, president of the National Abortion Federation. The trade group, whose members must meet care standards, has long excluded and criticized Brigham.
Grace Medical's website says it is in a suburb "just minutes from Philadelphia" in a "multi-story, multi-practice professional building." That fits Brigham's Voorhees headquarters.
The Voorhees facility, as well as his five other New Jersey locations, has never been approved to perform abortions beyond 14 weeks, when the fetus becomes too big to be extracted by mechanical suction. The charges explain the reason why: The clinics do not meet state safety requirements for outpatient surgery. Brigham has no hospital privileges if a patient needs emergency care. And he does not have certification from the Board of Medical Examiners, which requires doctors doing late abortions to have "superior training."
To skirt these rules, the charges say, Brigham exploited the complicated medical protocol used for late abortions: On the first day in Voorhees, he inserts absorbent rods to slowly widen the patient's cervix over 24 hours, and gives the fetus a lethal injection of digoxin. On the second day in Voorhees, the patient receives a labor-inducing drug called Cytotec. Then the patient and her driver follow Brigham to the Elkton clinic, where he dismembers and extracts the fetus.
The 18-year-old - one of three patients on Aug. 13 - told investigators their hour-long car caravan to Elkton was a surprise because she had been led to believe Voorhees staff would take her to a surgery center in Philadelphia.
"Transportation in a private vehicle for completion at a distant location is dangerous to the patient," the charges say.
Brigham falsified recovery room records to make his Elkton abortions appear to have been performed by Shepard or Walker, authorities allege.
Those records list terminations up to 33 weeks of pregnancy and payments, most ranging from about $900 to $2,600. Some patients are identified with the notation "Grace."
Maryland has temporarily suspended Shepard's license for aiding Brigham. It has also suspended Nicola Riley, a Utah physician whom Brigham hired in July to work part-time. No disciplinary action has been taken against Walker.
Under Brigham's guidance, Riley did the abortion that left the 18-year-old with a hole in her uterus and bowel, authorities say. Riley's three-page summary is handwritten on forms headed "Grace Medical Services."
Maryland has few restrictions on abortions performed after the fetus is "viable" - meaning able to survive outside the womb, at about 24 weeks. It allows such abortions to preserve the mother's health, or if the fetus has a serious abnormality.
Grace Medical's website says it specializes in caring for women who need late abortions because of maternal or fetal health problems.
Records released Monday of three post-viability abortions show one involved a 33-week-old Down's syndrome fetus, for which Grace Medical charged $21,900. But another case involved 25-week-old twin fetuses that the parents wanted to abort because they felt "stress" and regret that they had conceived through fertility treatment with donated sperm. In a third case, no health problems were documented - until the 20-year-old Pittsburgh woman could not go to the bathroom because of the absorbent rods.
She wound up being rushed from her hotel, in labor, to Virtua Hospital in Voorhees where she delivered a dead fetus.
Brigham has a history of doing abortions that straddle state lines. That was one of the reasons New Jersey restricted his license in 1993. He was accused of malpractice and incompetence in six abortions, including one started in his Voorhees clinic and completed in a facility he ran in New York at the time.
Brigham's license was stripped in New York, but in New Jersey, he got it restored after three years of appeals.
Back then, the prosecutors argued that Brigham's insertion of the absorbent cervical rods, called "laminaria," was tantamount to doing a late abortion in Voorhees. An administrative judge ultimately disagreed, saying the rules did not address the use of dilators.
This time around, investigators have documents that show Brigham not only inserted laminaria, but injected a drug to kill the fetus and gave another drug to induce labor - all in Voorhees.
Investigators also cite the consent forms that Brigham's patients must sign.
"Remember that your abortion really begins," says one form, "when the laminaria is inserted into your cervix."
Posted on Tue, Sep. 21, 2010
Inquirer Staff Writer
For more than a year online, "Grace Medical Care" has advertised abortions up to the last few weeks of pregnancy. It said it's located in a Philadelphia suburb, yet kept the address secret. And it has operated without the knowledge of state regulatory authorities.
Now, for the first time, the New Jersey Attorney General's Office says the person behind the clandestine enterprise is Steven Chase Brigham, the physician being investigated by New Jersey and Maryland on suspicion of licensing and criminal offenses.
Brigham's attorney, Joseph Gorrell of Roseland, N.J., did not return a call or e-mail requesting comment.
Brigham, 54, who has been in and out of trouble for much of his two-decade career, operates at least a dozen abortion clinics in New Jersey, Pennsylvania, Maryland, and Virginia under the name American Women's Services.
He has many other "entities," including Grace Medical Care, also called Grace Medical Services, say the attorney general's Sept. 8 charges.
Variations of Grace Medical turn up repeatedly in late-term abortion records recently seized from Brigham's offices.
Authorities said he initiated those abortions in the Voorhees headquarters of American Women's Services, then finished them the next day in Elkton, Md. - a scheme authorities say was designed to evade outpatient-surgery rules.
New Jersey is also looking into why state agencies that oversee businesses and medical facilities have no records for Grace Medical, said the attorney general's spokesman, Paul Loriquet.
Grace Medical remained a mystery even to doctors recruited by Brigham over the last year to work in Elkton, transcripts of interviews with investigators show.
Kimberly Walker, a young doctor who began training with Brigham in January, told investigators: "He basically calls the later-[term] cases, he calls them Grace patients. I don't know what Grace means."
George Shepard, an 88-year-old Delaware gynecologist hired as medical director at Elkton, was asked by investigators whether the Elkton facility was called "Grace something."
"I've heard the word Grace, but I'm not sure that they call it that," he responded. "All I know is Elkton."
The latest inquiry was launched after one of Brigham's bistate abortions went awry. An 18-year-old New Jersey woman who was 21 weeks pregnant suffered life-threatening complications Aug. 13 and had to be airlifted from Elkton to Johns Hopkins Hospital in Baltimore. She and a Hopkins physician later filed complaints.
Investigators soon discovered that Brigham has never had a medical license in Maryland. They also seized 35 frozen fetuses and fetal parts from Elkton, but they could not find medical records for 33 of those abortions either in Elkton or Voorhees.
Brigham has a hearing scheduled for Oct. 13 before the New Jersey Board of Medical Examiners to say why he should not lose his medical license there, the only state where he still has one. Pennsylvania, New York, and Florida took away his practice privileges in the 1990s.
Although Grace Medical Services was a regulatory phantom, it caught the attention of other abortion providers last summer. They were startled because its online ad explicitly offered "abortions up to 36 weeks" - two weeks shy of a full-term delivery - a risky procedure most doctors are loath to perform. The website said payments had to be in cash, while practically all providers accept health insurance. And not only was no address listed, but Grace Medical's phone receptionist would not readily divulge it.
Even in this era of heightened security amid fears of antiabortion violence, the secrecy seemed intended to hide the clinic, not protect it, said Vicki Saporta, president of the National Abortion Federation. The trade group, whose members must meet care standards, has long excluded and criticized Brigham.
Grace Medical's website says it is in a suburb "just minutes from Philadelphia" in a "multi-story, multi-practice professional building." That fits Brigham's Voorhees headquarters.
The Voorhees facility, as well as his five other New Jersey locations, has never been approved to perform abortions beyond 14 weeks, when the fetus becomes too big to be extracted by mechanical suction. The charges explain the reason why: The clinics do not meet state safety requirements for outpatient surgery. Brigham has no hospital privileges if a patient needs emergency care. And he does not have certification from the Board of Medical Examiners, which requires doctors doing late abortions to have "superior training."
To skirt these rules, the charges say, Brigham exploited the complicated medical protocol used for late abortions: On the first day in Voorhees, he inserts absorbent rods to slowly widen the patient's cervix over 24 hours, and gives the fetus a lethal injection of digoxin. On the second day in Voorhees, the patient receives a labor-inducing drug called Cytotec. Then the patient and her driver follow Brigham to the Elkton clinic, where he dismembers and extracts the fetus.
The 18-year-old - one of three patients on Aug. 13 - told investigators their hour-long car caravan to Elkton was a surprise because she had been led to believe Voorhees staff would take her to a surgery center in Philadelphia.
"Transportation in a private vehicle for completion at a distant location is dangerous to the patient," the charges say.
Brigham falsified recovery room records to make his Elkton abortions appear to have been performed by Shepard or Walker, authorities allege.
Those records list terminations up to 33 weeks of pregnancy and payments, most ranging from about $900 to $2,600. Some patients are identified with the notation "Grace."
Maryland has temporarily suspended Shepard's license for aiding Brigham. It has also suspended Nicola Riley, a Utah physician whom Brigham hired in July to work part-time. No disciplinary action has been taken against Walker.
Under Brigham's guidance, Riley did the abortion that left the 18-year-old with a hole in her uterus and bowel, authorities say. Riley's three-page summary is handwritten on forms headed "Grace Medical Services."
Maryland has few restrictions on abortions performed after the fetus is "viable" - meaning able to survive outside the womb, at about 24 weeks. It allows such abortions to preserve the mother's health, or if the fetus has a serious abnormality.
Grace Medical's website says it specializes in caring for women who need late abortions because of maternal or fetal health problems.
Records released Monday of three post-viability abortions show one involved a 33-week-old Down's syndrome fetus, for which Grace Medical charged $21,900. But another case involved 25-week-old twin fetuses that the parents wanted to abort because they felt "stress" and regret that they had conceived through fertility treatment with donated sperm. In a third case, no health problems were documented - until the 20-year-old Pittsburgh woman could not go to the bathroom because of the absorbent rods.
She wound up being rushed from her hotel, in labor, to Virtua Hospital in Voorhees where she delivered a dead fetus.
Brigham has a history of doing abortions that straddle state lines. That was one of the reasons New Jersey restricted his license in 1993. He was accused of malpractice and incompetence in six abortions, including one started in his Voorhees clinic and completed in a facility he ran in New York at the time.
Brigham's license was stripped in New York, but in New Jersey, he got it restored after three years of appeals.
Back then, the prosecutors argued that Brigham's insertion of the absorbent cervical rods, called "laminaria," was tantamount to doing a late abortion in Voorhees. An administrative judge ultimately disagreed, saying the rules did not address the use of dilators.
This time around, investigators have documents that show Brigham not only inserted laminaria, but injected a drug to kill the fetus and gave another drug to induce labor - all in Voorhees.
Investigators also cite the consent forms that Brigham's patients must sign.
"Remember that your abortion really begins," says one form, "when the laminaria is inserted into your cervix."
Voorhees doctor idle pending board action
September 11, 2010
NEWARK — A Voorhees doctor accused of moving
an abortion patient across state lines has agreed to
stop practicing medicine in the state until the Board
of Medical Examiners considers a move to suspend
his license.
According to the board, Dr. Steven C. Brigham
denies violating New Jersey statutes on the practice
of medicine, but has voluntarily agreed to stop
practicing so he can prepare his defense against the
board's allegations. He agreed on Friday to stop
practicing on Sept. 16.
The board will consider the attorney general's
application that Brigham's license be suspended at
its regular meeting on Oct. 13.
Authorities say Brigham started late-term abortions
at his clinic on Alpha Avenue in Voorhees, where he
wasn't permitted to perform them, and finished them
a day later in Maryland, where he has been ordered
to stop practicing.
NEWARK — A Voorhees doctor accused of moving
an abortion patient across state lines has agreed to
stop practicing medicine in the state until the Board
of Medical Examiners considers a move to suspend
his license.
According to the board, Dr. Steven C. Brigham
denies violating New Jersey statutes on the practice
of medicine, but has voluntarily agreed to stop
practicing so he can prepare his defense against the
board's allegations. He agreed on Friday to stop
practicing on Sept. 16.
The board will consider the attorney general's
application that Brigham's license be suspended at
its regular meeting on Oct. 13.
Authorities say Brigham started late-term abortions
at his clinic on Alpha Avenue in Voorhees, where he
wasn't permitted to perform them, and finished them
a day later in Maryland, where he has been ordered
to stop practicing.
N.J. probes abortion doctor's practice
By BEN NUCKOLS • Associated Press • September 10, 2010
VOORHEES — In early August, three women, each of
them more than four months pregnant, sought
abortions from Dr. Steven Brigham at his Voorhees
clinic. Instead of turning them down, authorities
said Brigham used a novel scheme to take advantage
of the disparities in state abortion laws.
He started the late-term abortions at American
Women's Services Inc. clinic at 1 Alpha Avenue,
where he wasn't permitted to perform them, and
finished them a day later in Maryland, where the law
is more permissive, authorities said.
One of the abortions, however, didn't go as
planned, and Maryland officials ordered Brigham, 54,
to stop practicing medicine in the state. Police
raided his offices and yanked two of his colleagues'
licenses in Maryland, and New Jersey authorities are
also seeking to take his license away.
Richard W. Westling, one of Brigham's attorneys,
said abortion doctors are frequently scrutinized and
his client stands behind his work.
"The matters currently being investigated involve
procedures that Dr. Brigham believes were legal,"
Westling said. "We are cooperating with the various
investigations and believe that a full airing of all of
the facts and legal issues is necessary before any
conclusions are reached."
Brigham's license has been suspended or revoked in
several states, but he has managed to continue
operating more than a dozen clinics. The new
allegations stunned even those familiar with his
notorious reputation, who said they had never
heard of a doctor initiating an abortion in one state,
then finishing it in another.
"His record is the most egregious one I know of in
the field," said Vicki Saporta, president of the
National Abortion Federation, an association of a
bortion providers, which has been warning
authorities about Brigham's practices since the mid-
1990s.
"He operates in his own economic interests and not
in the best interests of the women who seek his
care," Saporta said.
New Jersey permits all licensed doctors to perform
abortions for fetuses 14 weeks and younger, but
Brigham and his clinics lacked the certification
needed to perform a different procedure that's used
for later-term fetuses.
Maryland law is more flexible. Licensed physicians
can perform abortions at any time before the fetus is
deemed capable of surviving outside the womb, and
abortions of viable fetuses are permitted to protect
the life or health of the mother or if the fetus has
serious genetic abnormalities. Doctors generally
consider fetuses to be viable starting around 23
weeks.
New Jersey authorities claim that Brigham was
violating state law simply by beginning second-
trimester abortions in that state. Documents show
Brigham began dilating the cervix in New Jersey,
then removed the fetus the next day in Maryland.
While it's common for late-term abortions to be
performed over two days, documents show that
Brigham didn't even tell his patients they'd be going
to his clinic in Elkton, Md., about 60 miles away. He
simply led a caravan of vehicles, instructing patients
or their relatives to follow him, documents show.
Brigham graduated from Columbia University
medical school in 1986. He's the owner of the
Voorhees clinic and has 16 abortion clinics in New
Jersey, Maryland, Pennsylvania and Virginia.
The abortion business can be lucrative for the
relatively few doctors who perform the procedure
regularly, according to research by the Guttmacher
Institute. The median price in 2005 for an abortion
at 10 weeks was $430, and at 20 weeks, when the
procedure is more complicated, it was $1,260, the
Guttmacher Institute found.
Brigham charged $2,045 to the New Jersey patient
whose abortion was botched, documents show.
Authorities said Brigham's scheme could have
continued if they hadn't discovered the botched
procedure at his Elkton clinic.
An 18-year-old woman who was 21 weeks pregnant
had her uterus ruptured and her bowel injured, and
rather than call 911, Brigham and his colleague Dr.
Nicola Riley drove the woman to a nearby hospital,
where both were uncooperative and Brigham refused
to give his name, authorities said.
Documents filed in Maryland suggest that Brigham
and his staff frequently performed late-term
abortions. A search of the Elkton clinic revealed a
freezer with 35 late-term fetuses inside, including
one believed to have been aborted at 36 weeks.
Police who searched Brigham's offices in Voorhees
found only two medical records related to those
fetuses, documents show.
Brigham hasn't been cited for any wrongdoing
related to the storage of the fetuses.
A medical student who observed Brigham's work at
the Elkton clinic told investigators that she saw him
perform about 50 abortions there between January
and August, and that the majority involved women
in their second or third trimesters.
Allegations against Brigham first surfaced in 1992
in Pennsylvania, where he agreed to give up his
license amid an investigation of his practice,
according to published reports.
In 1993, he botched two late-term abortions in New
York, and his license was revoked for gross
negligence. According to public records, a 20-year-
old patient had to undergo an emergency
hysterectomy, and the other patient had her colon removed.
His Florida license was revoked in 1996 after he
secretly took over for a colleague who was killed by
an anti-abortion activist.
And in July, the Pennsylvania Department of Health
ordered him to close his four clinics in the state,
saying he employed unlicensed caregivers.
He's also had tax problems. In 1998, he was
sentenced to four months in jail for failing to file
corporate income tax returns and bilking insurance
companies in New York.
In April, the IRS placed more than $234,000 in liens
against him for failing to pay payroll taxes. He's
also subject to tens of thousands of dollars in state
tax liens.
Riley, meanwhile, had only been working with
Brigham for less than a month at the time of the
botched abortion. She was hired in July, she told
investigators, and she flew from her home in Salt
Lake City, Utah, to Maryland every other week to
perform abortions.
Kirt Linneman, executive director of the Maryland
chapter of the Center for Bio-Ethical Reform, an anti-
abortion group, said that while he believes all
abortions are immoral, women who seek them
should receive adequate care.
"We are appalled at the lack of regulation and
oversight of the abortion industry," Linneman said.
VOORHEES — In early August, three women, each of
them more than four months pregnant, sought
abortions from Dr. Steven Brigham at his Voorhees
clinic. Instead of turning them down, authorities
said Brigham used a novel scheme to take advantage
of the disparities in state abortion laws.
He started the late-term abortions at American
Women's Services Inc. clinic at 1 Alpha Avenue,
where he wasn't permitted to perform them, and
finished them a day later in Maryland, where the law
is more permissive, authorities said.
One of the abortions, however, didn't go as
planned, and Maryland officials ordered Brigham, 54,
to stop practicing medicine in the state. Police
raided his offices and yanked two of his colleagues'
licenses in Maryland, and New Jersey authorities are
also seeking to take his license away.
Richard W. Westling, one of Brigham's attorneys,
said abortion doctors are frequently scrutinized and
his client stands behind his work.
"The matters currently being investigated involve
procedures that Dr. Brigham believes were legal,"
Westling said. "We are cooperating with the various
investigations and believe that a full airing of all of
the facts and legal issues is necessary before any
conclusions are reached."
Brigham's license has been suspended or revoked in
several states, but he has managed to continue
operating more than a dozen clinics. The new
allegations stunned even those familiar with his
notorious reputation, who said they had never
heard of a doctor initiating an abortion in one state,
then finishing it in another.
"His record is the most egregious one I know of in
the field," said Vicki Saporta, president of the
National Abortion Federation, an association of a
bortion providers, which has been warning
authorities about Brigham's practices since the mid-
1990s.
"He operates in his own economic interests and not
in the best interests of the women who seek his
care," Saporta said.
New Jersey permits all licensed doctors to perform
abortions for fetuses 14 weeks and younger, but
Brigham and his clinics lacked the certification
needed to perform a different procedure that's used
for later-term fetuses.
Maryland law is more flexible. Licensed physicians
can perform abortions at any time before the fetus is
deemed capable of surviving outside the womb, and
abortions of viable fetuses are permitted to protect
the life or health of the mother or if the fetus has
serious genetic abnormalities. Doctors generally
consider fetuses to be viable starting around 23
weeks.
New Jersey authorities claim that Brigham was
violating state law simply by beginning second-
trimester abortions in that state. Documents show
Brigham began dilating the cervix in New Jersey,
then removed the fetus the next day in Maryland.
While it's common for late-term abortions to be
performed over two days, documents show that
Brigham didn't even tell his patients they'd be going
to his clinic in Elkton, Md., about 60 miles away. He
simply led a caravan of vehicles, instructing patients
or their relatives to follow him, documents show.
Brigham graduated from Columbia University
medical school in 1986. He's the owner of the
Voorhees clinic and has 16 abortion clinics in New
Jersey, Maryland, Pennsylvania and Virginia.
The abortion business can be lucrative for the
relatively few doctors who perform the procedure
regularly, according to research by the Guttmacher
Institute. The median price in 2005 for an abortion
at 10 weeks was $430, and at 20 weeks, when the
procedure is more complicated, it was $1,260, the
Guttmacher Institute found.
Brigham charged $2,045 to the New Jersey patient
whose abortion was botched, documents show.
Authorities said Brigham's scheme could have
continued if they hadn't discovered the botched
procedure at his Elkton clinic.
An 18-year-old woman who was 21 weeks pregnant
had her uterus ruptured and her bowel injured, and
rather than call 911, Brigham and his colleague Dr.
Nicola Riley drove the woman to a nearby hospital,
where both were uncooperative and Brigham refused
to give his name, authorities said.
Documents filed in Maryland suggest that Brigham
and his staff frequently performed late-term
abortions. A search of the Elkton clinic revealed a
freezer with 35 late-term fetuses inside, including
one believed to have been aborted at 36 weeks.
Police who searched Brigham's offices in Voorhees
found only two medical records related to those
fetuses, documents show.
Brigham hasn't been cited for any wrongdoing
related to the storage of the fetuses.
A medical student who observed Brigham's work at
the Elkton clinic told investigators that she saw him
perform about 50 abortions there between January
and August, and that the majority involved women
in their second or third trimesters.
Allegations against Brigham first surfaced in 1992
in Pennsylvania, where he agreed to give up his
license amid an investigation of his practice,
according to published reports.
In 1993, he botched two late-term abortions in New
York, and his license was revoked for gross
negligence. According to public records, a 20-year-
old patient had to undergo an emergency
hysterectomy, and the other patient had her colon removed.
His Florida license was revoked in 1996 after he
secretly took over for a colleague who was killed by
an anti-abortion activist.
And in July, the Pennsylvania Department of Health
ordered him to close his four clinics in the state,
saying he employed unlicensed caregivers.
He's also had tax problems. In 1998, he was
sentenced to four months in jail for failing to file
corporate income tax returns and bilking insurance
companies in New York.
In April, the IRS placed more than $234,000 in liens
against him for failing to pay payroll taxes. He's
also subject to tens of thousands of dollars in state
tax liens.
Riley, meanwhile, had only been working with
Brigham for less than a month at the time of the
botched abortion. She was hired in July, she told
investigators, and she flew from her home in Salt
Lake City, Utah, to Maryland every other week to
perform abortions.
Kirt Linneman, executive director of the Maryland
chapter of the Center for Bio-Ethical Reform, an anti-
abortion group, said that while he believes all
abortions are immoral, women who seek them
should receive adequate care.
"We are appalled at the lack of regulation and
oversight of the abortion industry," Linneman said.
N.J. seeks suspension of Voorhees abortion doctor's license
By BEN NUCKOLS • Associated Press • September 9, 2010
Authorities in New Jersey are seeking to suspend or
revoke the medical license of a doctor accused of
ferrying patients to Maryland to complete late-term
abortions.
Dr. Steven Brigham has already been cited for
practicing medicine without a license in Maryland.
On Wednesday, the New Jersey Attorney General's
office filed a complaint accusing him of illegally
performing late-term abortions.
Brigham was not authorized to abort fetuses older
than 14 weeks in New Jersey. Maryland law does not
specifically restrict second-trimester abortions.
New Jersey authorities accuse Brigham of initiating
abortions for three patients in Voorhees, then
leading them in a caravan to Elkton, Md., where the
procedures were concluded. Documents show
another physician botched the abortion of one of
those patients, forcing her to undergo emergency
surgery.
On Wednesday, attorneys for two doctors whose
licenses have been suspended after a botched a
bortion said their clients will be vindicated.
Dr. Nicola Riley and Dr. George Shepard were
scheduled to appear before the Maryland Board of
Physicians, but neither showed up. Riley's attorneys
asked for a postponement of the hearing, which was
granted. Shepard's attorney did not appear before
the board, and Shepard's suspension was upheld.
Both were employees of Brigham.
The Board of Physicians says Riley botched the
abortion and critically injured the 18-year-old
patient.
Riley's attorney, Christopher Brown, says there are
two sides to the story. Shepard's attorney, Jason
Allison, says his client's license should be
reinstated.
Authorities in New Jersey are seeking to suspend or
revoke the medical license of a doctor accused of
ferrying patients to Maryland to complete late-term
abortions.
Dr. Steven Brigham has already been cited for
practicing medicine without a license in Maryland.
On Wednesday, the New Jersey Attorney General's
office filed a complaint accusing him of illegally
performing late-term abortions.
Brigham was not authorized to abort fetuses older
than 14 weeks in New Jersey. Maryland law does not
specifically restrict second-trimester abortions.
New Jersey authorities accuse Brigham of initiating
abortions for three patients in Voorhees, then
leading them in a caravan to Elkton, Md., where the
procedures were concluded. Documents show
another physician botched the abortion of one of
those patients, forcing her to undergo emergency
surgery.
On Wednesday, attorneys for two doctors whose
licenses have been suspended after a botched a
bortion said their clients will be vindicated.
Dr. Nicola Riley and Dr. George Shepard were
scheduled to appear before the Maryland Board of
Physicians, but neither showed up. Riley's attorneys
asked for a postponement of the hearing, which was
granted. Shepard's attorney did not appear before
the board, and Shepard's suspension was upheld.
Both were employees of Brigham.
The Board of Physicians says Riley botched the
abortion and critically injured the 18-year-old
patient.
Riley's attorney, Christopher Brown, says there are
two sides to the story. Shepard's attorney, Jason
Allison, says his client's license should be
reinstated.
Doctor's four-state abortion business under investigation
By Marie McCullough
Posted on Fri, Sep. 3, 2010
Inquirer Staff Writer
Three weeks ago, physician Steven Brigham led a car caravan of patients from his Voorhees abortion clinic to his facility in Elkton, Md. After one of the patients was critically injured during her surgery there, Brigham put the semiconscious, bleeding woman into the back of a rented Chevrolet Malibu and drove her to a nearby hospital emergency room rather than call an ambulance.
Those details are contained in documents issued over the last 10 days by the Maryland Board of Physicians and Elkton police. The two agencies have launched a wide-ranging investigation into Brigham's long-troubled abortion business, which he conducts in New Jersey, Pennsylvania, Maryland, and Virginia.
On Aug. 25, the Maryland Board of Physicians ordered Brigham, 54, to stop performing abortions in that state, where he has never been licensed to practice medicine. By then police had raided Brigham's Elkton facility - from which they said they removed 35 "late-term fetuses and fetal parts" - as well as the Voorhees headquarters of his chain of 15 clinics, which does business as American Women's Services.
Maryland authorities seek missing medical records, and are looking into Brigham's habit of sending late-term patients across state lines after initiating their abortions in Voorhees.
Brigham's four New Jersey clinics cannot provide abortions after the first trimester (14 weeks of pregnancy) because they do not meet state safety requirements for such risky outpatient surgeries. Brigham has for years performed the first phase of such abortions there - the insertion of absorbent rods that dilate the patient's cervix over a day or more - and sent them to a facility in another state for the surgery. New Jersey law doesn't address whether inserting dilators constitutes abortion.
Brigham did not return a phone message left Thursday at his Voorhees condominium.
Maryland's action is just the latest problem for the doctor, whose medical license has been revoked, relinquished, or temporarily suspended in five states over the last 18 years.
In July, the Pennsylvania Department of Health revoked Brigham's permission to own clinics in the state because he had repeatedly employed unlicensed caregivers; he is appealing that decision. Brigham himself cannot perform medical procedures in Pennsylvania because of a confidential 1992 agreement in which he agreed to give up his license.
Brigham also had $234,536 in federal tax liens against him in April for failing to pay payroll taxes from 2002 to 2006.
Maryland regulators are investigating not only Brigham, but also two physicians he employed, the documents show.
On Tuesday, the board suspended the Maryland license of George Shepard Jr., a Delaware obstetrician-gynecologist hired in 2009 as a part-time medical director of Brigham's four Maryland clinics. The board has charged Shepard with unprofessional conduct and with helping Brigham flout credentialing requirements.
Shepard's lawyer, Jason Allison of Elkton, said, "We are reviewing the allegations and . . . are confident that Dr. Shepard's license will be reinstated."
On Tuesday, the Maryland board also suspended the license it granted less than two months ago to Nicola I. Riley, a family physician who in late July began flying "from her home in Utah every other week to Maryland to perform abortions." Riley did not return a call left with her mother in Utah.
It was Riley who mishandled the abortion on Aug. 13, according to the medical board documents. They provide this account:
On Aug. 12, an 18-year-old woman, 21 weeks pregnant, signed abortion consent forms at Brigham's Voorhees facility, at 1 Alpha Ave. Brigham then inserted the absorbent rods that widen the cervix.
On Aug. 13, the patient returned to the Voorhees clinic, with "the understanding that she would be provided transportation to Philadelphia" for the surgical phase of the abortion.
Instead, "Dr. Brigham . . . instructed [her] and the other women who were scheduled to complete abortions to form a line of cars and follow the lead car to a location where the abortion would be performed."
In Elkton, Riley gave the patient anesthesia under Brigham's direction and began the surgery, but cut through the patient's uterus into the bowel and vagina.
Riley informed the patient's mother and boyfriend of the complications, but refused to call for an ambulance. Riley "originally contemplated taking [the patient] by wheelchair to the hospital, which was about two blocks away."
Brigham drove Riley and the patient to the hospital, where the two abortion doctors dodged questions "about who they were, what had happened, and from where they had come."
The patient's injuries were so complex that she had to be flown by helicopter to Johns Hopkins Hospital while Riley "returned to the Elkton office . . . to perform another abortion."
A few days later, the patient complained to the Elkton police; they raided the clinic on Aug. 17, looking for the patient's medical record. Although that couldn't be found, police discovered frozen aborted fetuses and medical-waste records showing fetal ages up to 36 weeks. (A pregnancy is considered full-term at 38 weeks.)
On Aug. 20, Elkton police searched Brigham's Voorhees office for medical records that would explain the fetuses.
The officers "found only two medical records related to the fetuses," board documents say.
Staff from the New Jersey Attorney General's Office were on hand for the search, spokesman Paul Loriquet said. He added that he believed New Jersey's Board of Medicine, which oversees physicians, would take action soon.
The Maryland board moved against Brigham, Shepard, and Riley after a Johns Hopkins physician filed a complaint. The physician expressed concerns that patients were being put at risk by "being transported across state lines to complete medical care," board documents say.
Posted on Fri, Sep. 3, 2010
Inquirer Staff Writer
Three weeks ago, physician Steven Brigham led a car caravan of patients from his Voorhees abortion clinic to his facility in Elkton, Md. After one of the patients was critically injured during her surgery there, Brigham put the semiconscious, bleeding woman into the back of a rented Chevrolet Malibu and drove her to a nearby hospital emergency room rather than call an ambulance.
Those details are contained in documents issued over the last 10 days by the Maryland Board of Physicians and Elkton police. The two agencies have launched a wide-ranging investigation into Brigham's long-troubled abortion business, which he conducts in New Jersey, Pennsylvania, Maryland, and Virginia.
On Aug. 25, the Maryland Board of Physicians ordered Brigham, 54, to stop performing abortions in that state, where he has never been licensed to practice medicine. By then police had raided Brigham's Elkton facility - from which they said they removed 35 "late-term fetuses and fetal parts" - as well as the Voorhees headquarters of his chain of 15 clinics, which does business as American Women's Services.
Maryland authorities seek missing medical records, and are looking into Brigham's habit of sending late-term patients across state lines after initiating their abortions in Voorhees.
Brigham's four New Jersey clinics cannot provide abortions after the first trimester (14 weeks of pregnancy) because they do not meet state safety requirements for such risky outpatient surgeries. Brigham has for years performed the first phase of such abortions there - the insertion of absorbent rods that dilate the patient's cervix over a day or more - and sent them to a facility in another state for the surgery. New Jersey law doesn't address whether inserting dilators constitutes abortion.
Brigham did not return a phone message left Thursday at his Voorhees condominium.
Maryland's action is just the latest problem for the doctor, whose medical license has been revoked, relinquished, or temporarily suspended in five states over the last 18 years.
In July, the Pennsylvania Department of Health revoked Brigham's permission to own clinics in the state because he had repeatedly employed unlicensed caregivers; he is appealing that decision. Brigham himself cannot perform medical procedures in Pennsylvania because of a confidential 1992 agreement in which he agreed to give up his license.
Brigham also had $234,536 in federal tax liens against him in April for failing to pay payroll taxes from 2002 to 2006.
Maryland regulators are investigating not only Brigham, but also two physicians he employed, the documents show.
On Tuesday, the board suspended the Maryland license of George Shepard Jr., a Delaware obstetrician-gynecologist hired in 2009 as a part-time medical director of Brigham's four Maryland clinics. The board has charged Shepard with unprofessional conduct and with helping Brigham flout credentialing requirements.
Shepard's lawyer, Jason Allison of Elkton, said, "We are reviewing the allegations and . . . are confident that Dr. Shepard's license will be reinstated."
On Tuesday, the Maryland board also suspended the license it granted less than two months ago to Nicola I. Riley, a family physician who in late July began flying "from her home in Utah every other week to Maryland to perform abortions." Riley did not return a call left with her mother in Utah.
It was Riley who mishandled the abortion on Aug. 13, according to the medical board documents. They provide this account:
On Aug. 12, an 18-year-old woman, 21 weeks pregnant, signed abortion consent forms at Brigham's Voorhees facility, at 1 Alpha Ave. Brigham then inserted the absorbent rods that widen the cervix.
On Aug. 13, the patient returned to the Voorhees clinic, with "the understanding that she would be provided transportation to Philadelphia" for the surgical phase of the abortion.
Instead, "Dr. Brigham . . . instructed [her] and the other women who were scheduled to complete abortions to form a line of cars and follow the lead car to a location where the abortion would be performed."
In Elkton, Riley gave the patient anesthesia under Brigham's direction and began the surgery, but cut through the patient's uterus into the bowel and vagina.
Riley informed the patient's mother and boyfriend of the complications, but refused to call for an ambulance. Riley "originally contemplated taking [the patient] by wheelchair to the hospital, which was about two blocks away."
Brigham drove Riley and the patient to the hospital, where the two abortion doctors dodged questions "about who they were, what had happened, and from where they had come."
The patient's injuries were so complex that she had to be flown by helicopter to Johns Hopkins Hospital while Riley "returned to the Elkton office . . . to perform another abortion."
A few days later, the patient complained to the Elkton police; they raided the clinic on Aug. 17, looking for the patient's medical record. Although that couldn't be found, police discovered frozen aborted fetuses and medical-waste records showing fetal ages up to 36 weeks. (A pregnancy is considered full-term at 38 weeks.)
On Aug. 20, Elkton police searched Brigham's Voorhees office for medical records that would explain the fetuses.
The officers "found only two medical records related to the fetuses," board documents say.
Staff from the New Jersey Attorney General's Office were on hand for the search, spokesman Paul Loriquet said. He added that he believed New Jersey's Board of Medicine, which oversees physicians, would take action soon.
The Maryland board moved against Brigham, Shepard, and Riley after a Johns Hopkins physician filed a complaint. The physician expressed concerns that patients were being put at risk by "being transported across state lines to complete medical care," board documents say.
Subscribe to:
Posts (Atom)