Reflections on the Kermit Gosnell Grand Jury Report and Atlantic Women’s Medical Services By DFPC Staff January 30, 2011 Kermit Gosnell specialized in illegal late-term abortions. They were profitable, and he had the market to himself because of the illegality.1 Because the Delaware limit was 20 weeks, the Atlantic Women’s Medical Services (“AWMS”) in Wilmington, where Gosnell worked one day a week, referred late-term abortions to his Philadelphia office, where the limit was 24 weeks.2 According to the Grand Jury Report, Gosnell's abortion of Baby Boy A—estimated from photographs taken by staff to be 32 weeks—began at AWMS in Delaware where Gosnell received $2500, inserted laminaria, and administered pills to begin labor. He then told the patient to report to his Philadelphia clinic the next morning.3 One employee, Lynda Williams— charged with first-degree murder4 and ineligible for bail— allegedly severed the spinal cords of babies born alive. Williams originally worked with Gosnell at AWMS.5 Unqualified as a medical technician, she administered the lethal dose of drugs that killed one patient.6 Eileen O’Neill, an unlicensed medical school graduate, who posed as a doctor at the Philadelphia abortion clinic, met Gosnell through Leroy Brinkley, owner of AWMS.7 The Grand Jury recommended that the National Abortion Federation consider revoking 1 R. Seth Williams, District Attorney, Report of the Grand Jury (Jan. 14. 2011) at 27, available at http:// www.phila.gov/districtattorney/PDFs/GrandJuryWomensMedical.pdf. 2 Gosnell routinely ignored Pennsylvania’s 24-week limit, manipulating ultrasound images to make the fetal age appear younger. Id. at 81. He also defrauded the Delaware Pro-Choice Medical Fund by filing for compensation for abortions performed on non-Delaware residents. Id. at 89-90. 3 Id. at 100-103. 4 Id. at 14. 5 Id. at 35. 6 Id. at 51 (“improvise[d] her own drug cocktails”); id. at 68 (“routinely overmedicated patients”). 7 Id. at 40-44. the membership of AWMS.8 “[A]t least six patients were referred from Atlantic to Gosnell’s clinic in Philadelphia for illegal late-term abortions.”9 As in the case of Baby Boy A, these patients paid AWMS in Delaware for the illegal abortion and had laminaria inserted there before driving to Philadelphia for the denouement.10 The indifference to these events of Leroy Brinkley, owner of AWMS, appalled the Grand Jury. The director of Atlantic Women’s Medical Services, Leroy Brinkley, was unconcerned. He did not properly supervise the doctors he hired as “independent contractors” to assure that they were complying with the law. Remarkably, despite Gosnell’s long time association with Atlantic, Brinkley only produced three files for patients seen by Gosnell at Brinkley’s clinic.11 Delaware authorities should investigate Brinkley for condoning, facilitating, and profiting from Gosnell’s illegal activities.12 He allowed Gosnell to commence abortions illegally under Delaware law and to receive payment for them in Delaware. He also is an accomplice to Gosnell’s Pennsylvania crimes. They are birds of a feather. The parallels between Brinkley’s history and the Grand Jury Report are eerie. In addition to AWMS, Brinkley owns an abortion clinic in Baton Rouge, Louisiana. In August, 1988, the DEA investigated that clinic and discovered that the physicians employed by Brinkley were distributing unregistered controlled substances.13 After filing the proper applications, the doctors received DEA approval to dispense the controlled substances. However, a follow-up investigation found that the doctors had 8 Id. at 259-60. 9 Id. at 259. 10 Id. 11 Id. at 259-60. 12 A Delaware reporter sought unsuccessfully to learn more about Gosnell’s practice in the state. Sean O’Sullivan, Grisly Abortions Linked to Del., News-Journal, January 22, 2011, available at http://www.delawareonline.com/ article/20110122/NEWS01/101220341/Grisly-abortions-linked-to-Del. 13 United States v. Clinical Leasing Serv., Inc., 759 F. Supp. 310, 311-312 (E.D. La. 1990). dispensed controlled drugs on 100 occasions before the registration application was approved.14 Furthermore, the clinic—owned by Brinkley—failed to maintain proper records.15 The district court granted summary judgment for the government on liability.16 A jury subsequently assessed civil penalties of $278,000 against the physicians and $377,000 against Clinical Leasing Service, Inc. d/b/a Delta Women’s Clinic.17 The government then successfully brought suit against Brinkley and the other shareholder of Clinical Leasing Service to pierce the veil and hold them personally responsible for the $377,000 clinic penalty.18 The raid on Gosnell’s Philadelphia clinic that ended up disclosing the “baby charnel house”19 originated in a DEA investigation of Gosnell for allegations of violations of the Federal Controlled Substances Act,20 the same statute under which Brinkley had been fined. An episodic report on the web describes conditions at Brinkley’s Louisiana clinic that parallel descriptions in the Grand Jury Report. “Dust covered everything,” reports a young woman who had an abortion at Delta in 1998.21 “Dust everywhere” in Gosnell’s procedure rooms, states the Grand Jury Report.22 Brinkley’s customer chose the “twilight sedation.”23 14 Id. 15 Id. at 312. 16 Id. at 317. 17 United States v. Clinical Leasing Serv., Inc., 925 F.2d 120 (5th Cir. 1991), suggestions for reh’g en banc denied, 930 F.2d 304 (5th Cir. 1991). 18 United States v. Clinical Leasing Serv., Inc., 982 F.2d 900 (5th Cir. 1992). A decade and a half later, Brinkley coughed up almost $750,000 to pay the fine, penalties, and interest after a federal judge froze the assets of his four abortion clinics, two in Louisiana and two in Delaware. The court found that he had commingled his finances with the clinics to avoid the judgment. Clinic Owner Pays Federal Fine; Interest on the Debt Accrues for 17 years, Times-Picayune, Sept. 6, 2006, at 1. 19 Grand Jury Report, at 2. 20 Id. at 19 (law enforcement “had been investigating Gosnell and his clinic for months, based on reports of illegal prescription drug activity”). 21 Christina Dunigan, Delta Women's Clinic of Baton Rouge, RealChoice (Jan. 6, 2008), http:// realchoice.blogspot.com/2008/01/search-delta-womens-clinic-of-baton.html. 22 Grand Jury Report, at 46. See also id. at 201 (“dark layer of dust” on the baseboards). 23 Dunigan, supra note 21. Gosnell offered a menu of sedation for an extra charge. Patients picked how much they wanted and paid accordingly.24 The Louisiana physician was brusque and unfeeling.25 So was Gosnell.26 Gosnell’s clinic was filthy, smelly, and repulsive.27 A tour of the Delta Clinic by Baton Rouge TV station WAFB in 1998 disclosed “rusted surgical tools and blood on the floor.”28 The TV report prompted declaration of a health emergency by Governor Mike Foster and eventual passage of abortion clinic regulations.29 In 2002, the Louisiana State Board of Medical Examiners indefinitely suspended the license of Delta abortionist James Whitmore III “after finding him guilty of disregarding basic sanitation, being rude to patients and failing to realize how serious the condition was of a hemorrhaging patient who wound up needing a hysterectomy due to a perforated uterus.”30 According to a Board report, Whitmore improperly sterilized equipment and reused devices that were supposed to be used only once.31 Gosnell did the same thing.32 Records of the Louisiana Secretary of State indicate that that Brinkley is the listed officer for what is now called “Delta Clinic of Baton Rouge.”33 The shoddy history of Brinkley’s Baton Rouge clinic and his provision of a referral site for Gosnell to recruit late-term abortion patients in Delaware indicate that Atlantic Women’s Medical Services of Wilmington may be another 24 Grand Jury Report, at 53-57. Many abortion clinics offer sedation, but usually not for an extra charge. 25 Dunigan, supra note 21. 26 See section “Butcher of Women,” Grand Jury Report, at 6-8. 27 Grand Jury Report, at 2. 28 Abortion Clinic License Deadline Passes, The Advocate (Baton Rouge), Nov. 21, 2003. See Grand Jury Report at 20-21 (equipment “rusty and outdated”); id. at 50 (“blood on the floor”). 29 The Advocate, supra note 28. 30 Doctor's License Yanked; Board Says He Can’t Practice in State, Times-Picayune, Aug, 31, 2002, at 18. 31 Id. 32 See section “Gosnell used and reused unsanitary instruments to perform abortions,” Grand Jury Report, at 48-50. 33 Business Entity search conducted at http://www.sos.louisiana.gov/tabid/819/Default.aspx (Jan. 22, 2011). disaster awaiting to be disclosed. DEA investigators and the Delaware Board of Medical Licensure and Discipline should take a close look at Brinkley’s Delaware abortion business. After the hurtful neglect in Pennsylvania, the likely complicity of Brinkley in Gosnell’s criminal activity, and the disturbing parallels between Brinkley’s abortion operation in Louisiana and Gosnell’s Pennsylvania practices, Delaware officials have no excuse for failing to scrutinize him. The Grand Jury was sufficiently disturbed at Brinkley’s behavior and his fostering of Gosnell’s crimes to add a paragraph recommending decertification of AWMS. This warning should stir Delaware regulators to action. The Delaware Medical Practice Act sets out a duty to report unprofessional conduct.34 Brinkley and AWMS had such a duty. Did they report Gosnell’s commencement of illegal abortions in Delaware? Was Brinkley responsible for knowing what his employee was doing? 35 The Grand Jury report thought he should have been.36 Brinkley employed one of the nastiest abortionists known to American history. His history of abortion clinic operation echoes Gosnell’s derelictions. These two long-term abortion businessmen appear to have disquieting similarities in their methods of operation. Did these compatibilities make them collaborators in crime? Are not Brinkley and AWMS ripe for investigation? 34 All certified, registered, or licensed healthcare providers, and all healthcare institutions in the State have a duty to report unprofessional conduct by a physician. Del. Code Ann. tit. 24, § 1731A. This duty includes “conduct that would constitute a crime substantially related to the practice of medicine” Id., § 1731(a)(2). 35 Senate Bills 297 and 298 (eff. June 30, 2010) increase the penalties for failure to report unprofessional conduct. See Summary of 2010 Legislation impacting licensed medical providers, http://dpr.delaware.gov/boards/ medicalpractice/documents/Summary%20of%202010%20Legislation.pdf. 36 Grand Jury Report, at 259-60.