Last Wednesday afternoon, a California teen-ager died at a hospital in Pleasonton, Calif., days after taking prescription pills to abort her early pregnancy.
The circumstances surrounding her death are unclear and an autopsy is under way. But battle lines are already being drawn.
Opponents of abortion say the death of Holly Patterson, 18, shows why the abortion pills are too dangerous to remain on the market, while abortion providers say that the death, while tragic, shows no such thing.
"We're sorry to say that this is what we warned would happen," said Wendy Wright, senior policy director for Concerned Women of America, a group that opposes abortions. "This is a drug that needs to be taken off the market."
Ron Fitzsimmons, the executive director of the National Coalition of Abortion Providers, said it was not clear why Patterson died but Wright's reaction was no surprise.
"We expect the anti's to jump all over it," he said.
The pill, mifepristone, formerly known as RU-486, has long had a symbolic significance transcending its medical use.
When it was approved by the Food and Drug Administration three years ago, advocacy groups insisted that it would change the nature of abortions, taking them out of clinics, where women might be subjected to harassment by abortion opponents, and into the privacy of the doctor's office.
Abortion opponents said it was dangerous and would lead to suffering and deaths.
So far, neither has been right. Eighty-eight percent of abortions occur in clinics, said Pamela Long, a spokeswoman for Danco Laboratories of New York, mifepristone's distributor.
While more and more women are having medical abortions, not all clinics offer them and just 18 percent of eligible women choose them, according to Vicki Saporta, the president of the National Abortion Federation.
On the other hand, said Dr. Richard Hausknecht, Danco's medical director, "the drug has turned out to be quite safe, quite effective."
About 160,000 to 165,000 American women used the drug from Sept. 28, 2000, when it was approved, to the end of March 2003.
One woman in Canada died of an infection during the drug's clinical trials, and an American woman who had an undetected tubal pregnancy died after she took the drug.
Patterson received mifepristone Sept. 10 from Planned Parenthood Golden Gate, a clinic near her home in Livermore, a San Francisco suburb. Erin Brooks, a clinic spokeswoman, said she could not reveal any details because of patient confidentiality regulations.
The FDA requires that women be counseled about the procedure, sign informed consent documents, and be provided with phone numbers of medical personnel in case of complications.
Some news reports say Patterson had severe pain and bleeding Sept. 14 and went to a hospital, which sent her home with painkillers. She returned Sept. 16 and died the next day.
"She didn't have someone to care for her who recognized the danger she was in," said Dr. Donna Harrison, an obstetrician-gynecologist in Berrien Springs, Mich. She is the author of a petition by the American Association of Pro-Life Obstetrician-Gynecologists asking that mifepristone be removed from the market.
"That is the crux of our complaint," she said. "Mifeprex has effectiveness, it does work," she said, referring to the drug by its brand name. But, she added, "This is a dangerous drug that is essentially unregulated, which makes it more dangerous."