A state medical panel upheld a suspension order Wednesday against an obstetrician who ran a clinic in which an 18-year-old woman was badly injured during an abortion.
Neither the doctor — George Shepard Jr., 88, who oversaw the five Maryland clinics of American Women's Services — nor his attorney appeared at the hearing in Baltimore of the Maryland Board of Physicians that was to hear evidence against him in the case of the woman, who suffered a perforated uterus and other injuries during an Aug. 13 procedure in Elkton.
The medical licenses of Shepard and another doctor, Nicola I. Riley, 45, were suspended last week. A third doctor in the case, Steven C. Brigham, 54, who state officials say owns the chain of clinics, was not licensed to practice medicine in Maryland and was ordered to stop doing so.
Riley, a family doctor who obtained her Maryland license July 20 and who medical officials say performed the Aug. 13 abortion under Brigham's instructions, was at home Wednesday in Salt Lake City. Two lawyers appeared at the hearing on her behalf and asked for a continuance on the grounds that they had not had sufficient time to prepare a defense. The 12 board members granted the continuance but did not set a date for a new hearing. In the meantime, Riley's license remains suspended.
"She's going to fight to keep her license," said Christopher C. Brown, one of Riley's lawyers. Her other attorney, Sharon Krevor-Weisbaum, added that Riley "should be reinstated."
The three doctors' actions came to light after a surgeon at a Baltimore hospital was forced to perform an emergency operation on the young woman to repair damage from the procedure she underwent at the Elkton clinic.
C. Irving Pinder Jr., the executive director of the physicians board, said that even though Brigham was unlicensed in Maryland, he could still be fined $50,000 for each incident of malpractice, and law enforcement agencies were looking into the possibility of charging him with felonies. The other two doctors could also be charged, and the physicians' board retains the option of reprimanding them, revoking their licenses, placing them on probation or dismissing their cases.
In an unrelated case, board members signed a suspension order for a Severna Park abortion doctor whose patient, a 21-year-old woman, died of an overdose of anesthesia during surgery. The doctor, Romeo A. Ferrer, who obtained his Maryland physician's license in 1971, "failed to meet appropriate standards for the delivery of quality medical care" during the operation on Feb. 3, 2006, the suspension order says.
The woman in that case, the mother of a 3-year-old boy, was 16 weeks pregnant and healthy at the time of the abortion, according to the document. An autopsy indicated that she died of "Meperidine intoxication," a reference to a narcotic analgesic.
Board investigators concluded that a second dose, given to the patient just five minutes after the first, "was too large and administered too quickly" and that Ferrer and his team failed to properly monitor her pulse and blood pressure. When the woman's fingernails turned blue, a sign that she was deprived of oxygen, Ferrer "failed to provide adequate resuscitative efforts," the document says.
Paramedics were unable to revive the patient, who was later pronounced dead at Anne Arundel Medical Center. The case came to the attention of the physicians board after the woman's family sued Ferrer. He was being served with the suspension order Wednesday but could not be reached for comment.
In the Elkton case, board investigators said the procedure on the woman, who was 21 weeks pregnant, began at an AWS clinic in Voorhees, N.J., where the dilation of her cervix was initiated. The next morning, she and two other patients were told to travel in their own cars to the AWS clinic in Elkton, a 60-mile trip, for the actual abortions, a tactic that evidently took into account that Maryland law — unlike New Jersey's — does not address the issue of late-term abortions.
In Elkton, the documents say, Riley bungled the abortion, and she and Brigham decided to drive the woman to a nearby emergency room. Once there, the two doctors were "circumspect" about who they were and where the bleeding, semiconscious patient had come from, the documents say, but demanded that ER doctors come out to meet them rather than taking the woman inside themselves.
Their actions created "a lot of confusion," said Pinder, the physicians' board director, and "posed a danger to the public" by delaying the woman's treatment.
Shepard was not thought to have been directly involved in the woman's surgery, Pinder said, but he was "aiding and abetting the practice of medicine by an unlicensed professional," the latter a reference to Brigham. Pinder said the board, which has jurisdiction over doctors but not clinics, was investigating "all the practitioners" in the five AWS clinics in Maryland.
"Once you start peeling the onion," he said, "you tend to find a lot more problems."