Physician Kermit Barron Gosnell had an unusual reaction to the death of Karnamaya Mongar in November 2009. The next day, he applied to join the National Abortion Federation, whose membership is often seen as a badge of quality.Rather than try to clean up his practice and cease performing illegal late term abortions - those in the third trimester that were illegal under Pennsylvania law, he made an cursory effort to join a professional group that would give him credibility where none existed.
To prepare for a site visit, Gosnell and his wife, Pearl, frantically cleaned the facility, replacing bloody recliners and temporarily hiring a professional the clinic had long lacked: a nurse.
His failed effort to bluff his way through the application appalled prosecutors. But worse, they said, "he made no effort to address the grave deficiencies in his practice that had caused Karnamaya Mongar's death."
The NAF refused him entry citing irreparable errors and problems. That should have been a red flag for anyone involved, but Gosnell preyed on his patients - knowing that they weren't sophisticated enough to know whether Gosnell was skilled or licensed to perform abortions and whether he was engaging in proper sanitary conditions.
That it was abundantly clear to investigators when they raided his office on unrelated pill mill charges that Gosnell did not give a rat's ass about sanitary conditions, or patient health beyond collecting the fee for the abortion procedures is obvious. What isn't obvious is how Gosnell was able to get away with this for so long.
Gosnell had an earlier run-in with health officials after carrying out a test of a new abortion device in the early 1970s, but no charges were filed. And as the years went on, his reputation fell in proportion to his need to court out-of-state patients for his practice:
In 1972, he played a prominent role in a scandal over an experimental abortion tool called "the super coil," designed for use in the second trimester.And when the State Health Department did receive complaints about Gosnell, they closed the files without so much as carrying out an investigation - even when the patient involved died.
California psychologist and activist Harvey Karman had developed the coil. Gosnell tested it on 15 poor women who had taken a bus from Chicago on Mother's Day weekend because they couldn't get abortions elsewhere.
Federal and city health officials later found that nine of the women had suffered serious complications, including a punctured uterus. One needed a hysterectomy.
Gosnell was not charged, but Karman spent two years in court battles with Philadelphia District Attorney Arlen Specter before getting cleared.
In his early years, Gosnell had a good reputation in part because he made house calls.
But he was also known for pushing the limits. His methadone clinic once employed 25 people, Edmonds said, before it unraveled.
State tax liens piled up against the clinic through the 1980s and 1990s, and it folded.
Gosnell also became more reckless in his abortion practice, which was hit by a $41,000 federal tax lien.
He couldn't get doctors to refer patients because of his declining reputation. So he increasingly relied on attracting women from out of state. He even provided a bed in the clinic for overnight stays, the grand jury report said.
Gosnell carried out abortions that other clinics wouldn't touch - primarily because they were illegal. His was a case of a licensed abortionist carrying out illegal late-term abortions in conditions no better than the back-room abortions that pro-choice advocates contend would occur should abortions become illegal.
Will anyone in Pennsylvania heed the lessons to be learned from this case and make sure that abortion/family planning centers are adhering to the law and providing proper care to their patients?