Charges against the doctor were dropped by the Cecil County state prosecutor because he could not find enough evidence to demonstrate where the procedures occurred. The Elkton clinic is no longer listed on the website of American Women's Services.

The facilities penalized by the state this week are listed on the website of American Women's Services, but Wilson said the clinics are owned by Integrity Health in Pennsylvania.

"Associates in OB/GYN Care addresses are listed on the American Women's Services because they help with our online presence and other marketing efforts," Wilson said in an email.

State health officials were criticized in a letter by members of the Maryland House of Delegates last month for not inspecting and licensing new facilities quickly enough. The criticism came after a New York teacher died Feb. 7 at Shady Grove Adventist Hospital after an abortion at Germantown Reproductive Health Services.

The state medical examiner eventually ruled that 29-year-old Jennifer McKenna Morbelli died from amniotic fluid that had leaked into the bloodstream, a complication of the abortion. But the autopsy didn't find negligence by the doctor.

Still, the incident raised questions about the clinic and its doctors. Some questioned why the clinic wasn't immediately shut down and inspected more quickly.

Sharfstein said Friday that inspections found no safety reasons to close the facility.

Del. Nicholaus Kipke, an Anne Arundel County Republican on the House Health & Government Operations Committee, was lead writer of the letter signed by 16 other members.

Kipke said the Germantown facility is being investigated further by the state. He said he was glad to learn Maryland clinics were being inspected because the regulations only work with enforcement.

"Some of these operations are really reminiscent of the back-alley abortions we had in the old days," Kipke said. "Whether you are pro-choice or pro-life, I think everyone should agree if abortion is going to be allowed, it should be safe, and Maryland is moving forward with that by making sure clinics are held to the highest standards."

The letter from lawmakers also questioned whether the department was looking into clinics that advertised abortions, but had not gotten licenses.

Sharfstein said Friday that identifying unlicensed clinics is part of the process.

Jeffrey Meister, a lobbyist for anti-abortion group Maryland Right to Life, said his organization supported regulations that would have been more stringent, but agreed that what is in place will better protect women.

"The regulations were put in place by DHMH specifically for the health and safety of women," he said.

An earlier version contained incorrect information about where the Baltimore clinic's patient died. The Sun regrets the error.

andrea.walker@baltsun.com

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