Two doctors who Maryland authorities say botched an abortion last year in Elkton have been indicted on murder charges — in what appears to be the first use of the state's fetal homicide law involving a medical professional performing surgery.
"We're in uncharted territory," Cecil County State's Attorney Edward D.E. Rollins said Friday. He declined to comment further because the indictment remains sealed until the suspects are arraigned in Maryland. They were arrested Wednesday in New Jersey and in Utah.
Dr. Steven Chase Brigham, 55, of Voorhees, N.J., faces five counts of first-degree murder, five counts of second-degree murder and one count of conspiracy to commit murder. Dr. Nicola Irene Riley, 46, of Salt Lake City faces one count each of first- and second-degree murder and conspiracy to commit murder.
Authorities would not describe the indictment in detail. A statement from Elkton police says some of the charges relate to an abortion that went awry 16 months ago. Detectives investigating that case — in which a teenager had to be rushed to a hospital and survived — said they found nearly three dozen late-term aborted fetuses in a freezer in Brigham's Elkton clinic.
Maryland is one of 38 states with a fetal homicide law. But unlike many, Maryland does not define when it is too late to perform an abortion. Under the law, enacted in 2005, it is illegal to abort a fetus deemed viable, or showing signs of healthy development.
Prosecutors in Maryland have used the law several times, mainly in cases involving shootings or beatings of pregnant women. The first conviction came in 2008 after a Parkville man killed his wife and their unborn baby in the 32nd week of her pregnancy.
The case in Elkton prompted the General Assembly to debate whether stricter regulations are needed for abortion clinics, and state health officials are drafting new guidelines to exert better control over doctors who perform the procedures.
"We want regulations that can avert an Elkton-like situation in the future," said Frances B. Phillips, deputy director of public health services for the Maryland Department of Mental Health and Hygiene.
An anti-abortion group said the charges in Cecil County prove that Maryland's liberal abortion laws are incapable of regulating the industry and need to be overhauled to prevent similar problems. A group that represents abortion clinics nationwide called the Elkton suspects "outliers" and said the charges prove that the laws are adequate to handle cases outside acceptable medical standards.
Attorneys for the two doctors say the charges are unwarranted. Both are being held in their respective states pending extradition to Maryland.
"We believe the charges are without legal merit," said Riley's Baltimore attorney, Sharon Krevor-Weisbaum. She declined to comment further.
Brigham's lawyer, C. Thomas Brown of Elkton, issued a statement saying that his client has "fully cooperated with this investigation" and that he had an agreement with the state's attorney's office for the suspect to surrender.
"For reasons unknown to me, the state did not honor that agreement," Brown said. "We do not believe that Dr. Brigham has violated any Maryland laws."
Rollins denied Brown's assertion that he had made a deal for Brigham to surrender. "I'm not aware of any agreement that we had for him to turn himself in," the prosecutor said.
The Elkton case broke in August 2010 when an 18-year-old woman from New Jersey suffered a ruptured uterus and other internal injuries during a procedure at the American Woman's Services clinic on East High Street.
The Maryland Board of Physicians found that the woman, who was 21 weeks pregnant, had initially been treated in Voorhees, N.J., where her cervix was dilated. The woman was then told to travel in her own car to Elkton, a distance of about 60 miles, so doctors could complete the procedure.
After the woman's uterus ruptured, state officials said, Riley put her in Brigham's rented Chevrolet Malibu and drove her to Union Hospital in Elkton. The board said she sat in slumped in a wheelchair, nearly unconscious, outside the emergency room while Riley argued with hospital staff, who demanded their identities before treating the woman.
The woman was flown that day to Johns Hopkins Hospital in Baltimore for further treatment. State officials said Riley then returned to the clinic in Elkton to perform another abortion.
Maryland's abortion law, which is less restrictive than those in nearby states, might explain why the procedure was initiated elsewhere and completed in Elkton, an issue the state physician's board said violated standard medical practices and endangered the woman's life. In other states, later-term abortions must be performed at a surgical center or hospital rather than a doctor's office. In New Jersey, pregnancies after 14 weeks cannot be ended at doctors' offices.
Elkton police said they searched the clinic but could not find medical records for the woman. But police said they found 35 later-term fetuses, some 20 to 35 weeks old, in a freezer. The Philadelphia Inquirer has reported that Brigham's four New Jersey clinics cannot perform abortions after the first trimester — 14 weeks of pregnancy — because they did not meet safety standards.
Riley's medical license was suspended in September 2010 by Maryland authorities; Brigham, who did not have a Maryland license, was barred from practicing in the state. Both doctors had previously lost their licenses to practice medicine or run clinics in several states, including New York and Pennsylvania.
Another doctor at the clinic, George Shepard Jr., 88, also had his Maryland license suspended by the Board of Physicians, but he has not been charged with a crime. State authorities said Brigham ran a string of clinics in several states, including Pennsylvania and New York. His Maryland clinics were located in Elkton, Baltimore, College Park, Frederick and Cheverly.
Phillips, the deputy public heath director for the Maryland Department of Mental Health and Hygiene, said the state's new regulations are posted on the Internet and will be open to 30 days of public comment starting in mid-January.
The proposed rules would tighten state authority over abortion clinics. Phillips said state officials had no authority over the clinic in Elkton.
"We did not have the authority for the state to knock on the door and look at the records," she said. "We weren't there. We had no standing to go into the clinic."
That would change if the proposed rules go into effect. She said every abortion clinic would be required to have a doctor licensed in Maryland on staff, established procedures for emergency transport of patients to hospitals and scrutiny of any clinic wanting to accept patients from other states.
"We want to focus on what we need to do to ensure that women in Maryland have save procedures," Phillips said. "We want standards in place in all the surgical abortion clinics."
Cheryl Sullenger, the senior policy adviser for the anti-abortion group Operation Rescue, based in Kansas, applauded the arrests of the doctors and criticized Maryland officials for allowing what she called a "secret abortion clinic" to operate in Elkton.
The group has tracked this case from the beginning, and Sullenger said her staff had warned officials in other states about the doctors long before the Elkton incident became public.
Sullenger said Maryland's law concerning when a fetus is viable, which avoids defining it by number of weeks, makes the state "a magnet for late-term abortionists. It's pretty much wide open. They don't check on you. They don't have any kind of regulations.
"This should be a wake-up call for the people of Maryland that in order to protect women in incidents like this, they need to enact strict laws and enforce them."
But Vicki Saporta, president of the National Abortion Federation in Washington, said no new laws are needed.
"Maryland has a constitutional fetal viability law," she said. "There doesn't need to be any change in the law, and to our knowledge, the law is being followed by legitimate abortion providers in Maryland."
Saporta said the doctors in the Elkton case are accused of practicing "outside the acceptable standards of care and outside the law. Passing new laws will do nothing to curb those practices."
Baltimore Sun reporter Meredith Cohn and the Associated Press contributed to this article.