Tuesday, April 17, 2012

1998: Frantic, Bleeding Woman Reassured and Abandoned by Doc

Those insist that legalization of abortion is necessary to keep our daughters safe might want to speak to Lou Ann Herron's father, Mike Gibb, who silently wept in the courtroom as he listened to witnesses describe how his daughter died on April 17, 1998 from a safe-n-legal abortion at the now defunct A-Z Women's Center.

The Pregnancy

Medical assistant Sylvia Aragon wept on the witness stand as she said that Lou Ann's pregnancy was "too far along" for an abortion.

If the abortion was indeed being done after 24 weeks, Arizona law requires that two physicians be present. Dr. John Biskind (pictured) was the only physician attending Lou Ann's abortion. Arizona law also limits abortions after 24 weeks to those that an abortionist can try to justify on the grounds that it was necessary to preserve the health and safety of the mother -- a nonsensical concept, since after 24 weeks a conscientious physician faced with a gravely ill patient will perform an emergency c-section in a hospital operating room; he will not perform a risky late abortion in a freestanding clinic.

There were no health concerns in Lou Ann's case anyway, the prosecution noted. She sought the abortion because she already had two children and was separated from her husband.

The Abortion

Prosecutors said that Biskind had ordered a total of seven ultrasounds performed, with estimates ranging from 23 weeks 3 days to 26 weeks. However, only the ultrasound that showed the pregnancy as 23 weeks 3 days was forwarded to the medical examiner; the others were lost or destroyed by the facility.

The abortion was performed at 1:30 p.m. Biskind, his lawyer said, noted a small amount of blood on the sheets when he checked on Lou Ann after the abortion, but that he was not concerned because bleeding is normal after an abortion.

The Aftermath

Two medical assistants testified that Lou Ann was very frightened about her condition as she lay in recovery. She begged, they said, to know what was wrong with her. She cried out in pain as she lay in a puddle of blood for three hours. Biskind fixed her IV (complaining that there was no qualified nurse on staff to do this), reassured her, and left the building at around 3:45 p.m.

Clinic administrator Carole Stuart-Schadoff had a staffer page Biskind 25 minutes later when Lou Ann's condition worsened. Biskind did not return to the clinic, but told staff to call 911.
Prosecutors estimate that by the time paramedics were summoned, Lou Ann had lost 2 to 3 liters of blood.

When the rescue crew arrived, Phoenix fire captain Brian Tobin Tobin testified, Lou Ann was wearing an oxygen mask, but had not been intubated. There was also no IV in place. "I very quickly felt that there wasn't a lot of competent medical care going on at the time," he said.
Nobody at the clinic seemed aware of how grave her condition was, he said, and nobody seemed to be helping her in any way. Staff told Tobin that Lou Ann's vitals were pulse 100, blood pressure 90/50. "It was very difficult for me to believe that they could get the vital signs of a woman who, even as we walked in the door, looked really dead," he said.

The Trial

A former Maricopa County medical examiner testified that the tear in LouAnne's uterus was caused by medical instruments, and not by a fetal body part as the defense suggested. However, even had the injury been caused by a fetal body part, this is an expected complication and would not have excused Biskind from his duty to notice and treat the injury.

Emergency room physician John Gallagher testified that, based on his assessment of Lou Ann's condition, she could have been saved had she been brought into surgery promptly.

Gallagher noted that during her last hours in the recovery room, Lou Ann became combative, anxious and frightened, and that she reported her legs were going numb. These, he noted, are all clear signs of severe blood loss. Instead of recognizing the danger she was in, Gallagher noted, Biskind instead tried to calm Lou Ann and reassure her that she would be "just fine."

Dr. Sidney Wecsler, an abortion expert testifying for the prosecution, said that the letter Biskind wrote to the medical board describing Lou Ann's death misrepresented both her condition and his treatment of her. The letter, dated June 1, 1998, said that Boskind checked on Lou Ann at 1:25 p.m., and that "pulse and blood pressure were satisfactory." The medical records, however, show that Lou Ann's blood pressue was low at that time, a symptom of severe blood loss. Biskind also said in the letter that Lou Ann was alert and talking when he left the clinic at 4:05, which Wecsler said would have been impossible for the moribund patient who was certainly dead by the time paramedics arrived twenty minutes later.

Wechsler said that Biskind surely knew as early as 3:15 p.m. that Lou Ann was not alert, because he ordered a drug to arouse her, which did not work. Biskind's letter makes no mention of administering this drug.

A doctor who specializes in obstetric ultrasounds testified that the quality of the scan used to justify Lou Ann's abortion was so poor that it appeared the machine was defective and improperly used.

Biskind's co-defendant, Carole Stuart-Schanoff, had a defense based on the idea that as administrator of the facility, she had no medical training, took no role in patients' medical care, and therefore was not responsible for what happened in the clinic she was running. Prosecutors point out that Stuart-Schadoff scheduled the abortion, and that she scheduled it despite knowing that there would be no registered nurse attending the recovery room that day. The prosection also noted that Stuart-Schadoff delayed calling 911, choosing to call Biskind first.

Lois Montagno, an RN from the now closed A-Z Women's Center, testified that she told Stuart-Schadoff a week in advance that she would not be able to work past noon on August 17, 1998, the day Stuart-Schadoff scheduled Lou Ann Herron for her fatal abortion.

Upon retiring to deliberate at 1:30 p.m. on Tuesday, the jury of seven women and one man immediately agreed that the defendants were guilty. It was simply a matter of deciding which charges they were guilty of: the manslaughter charge, or the lesser charge of negligent homicide. It took them 4 1/2 hours to conclude that Biskind was guilty of manslaughter, Stuart-Schadoff of negligent homicide.

Lou Ann's family, which occupied two rows of the courtroom during the trial, wept as the verdicts were read. They met with members of the jury afterward.

Jury foreman Russell Craig, 56, spoke for the jury in the aftermath of the abortion death trial. He reported that he and other jurors were haunted by vivid dreams. He was particularly disturbed by the autopsy photos.

According to Craig, Biskind was his own worst enemy. "At one point when the prosecutor had finished his closing arguments," Craig told a reporter, "he applauded. It certainly didn't make much of an impression."

Only after the trial was over did members of the jury learn of Biskind's history of misconduct, including the previous death of another abortion patient. Craig said that this information "makes me feel better about my decision."

After the verdict, County Attorney Romley called for tougher laws addressing the way the Board of Medical Examiners handles doctors with problems.

The Owner

A-Z owner Moshe Hachamovitch admitted that the clinic did not have a procedures manual, but said that Biskind was "excellent at doing second-trimester abortions." Hachamovitch indicated that he himself is an expert on late abortions, having performed "hundreds of thousands of them" during his 41 years of practice, going back to pre-Roe days in New York. However, Hachamovitch's license had been suspended in New York for nine months on the grounds of gross negligence, gross incompetence, and innacurate patient records. His license was again suspended in New York for practicing fraugulently and failing to maintain adequate records.

Hachamovitch himself performed the fatal abortions on Tanya Williamson, Luz Rodriguez, and Christina Goesswein. Jammie Garcia died after a safe and legal abortion at Hachamovitch's Texas facility.

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