By Dave Andrusko
The murder trial of West Philadelphia abortionist Kermit Gosnell began its second week on Monday. We talk about what witnesses said at “Gosnell Jury Hears more about death of Karnamaya Mongar.” It makes for rough sledding, so be prepared.
Likewise for today’s excerpt from the Grand Jury report that formed the basis for the indictment of Gosnell on seven counts of first degree murder—for the seven viable babies aborted alive and then, according to prosecutors, murdered when their spinal cords were cut—and one count of third degree murder–in the case of Karnamaya Mongar, who died during a November 19, 2009 abortion from what prosecutors say was an overdose of sedatives and narcotics administered by Gosnell’s untrained staff. The excerpt shows the Grand Jury concluding that not only did Gosnell routinely perform abortions past the state limit of 24 weeks, but did so knowingly. To cover up what he was doing, Gosnell would “redo the ultrasound, or staff members would be ordered to do so, to produce a different gestational age to record in the patient’s file.”
Gosnell routinely performed abortions past Pennsylvania’s 24-week limit
Several of the clinic’s former staff told the Grand Jury that Gosnell performed many, many abortions beyond the legal limit in Pennsylvania – a gestational age of 24 weeks. Their testimony is confirmed by clinic files, by fetal remains found at the facility, by photographs of babies that Gosnell delivered and then killed, and by a 30-plus-weeks baby girl born dead at a hospital after Gosnell had inserted laminaria to begin a third trimester abortion.
Steven Massof estimated that in 40 percent of the second-trimester abortions performed by Gosnell, the fetuses were beyond 24 weeks gestational age. Latosha Lewis testified that Gosnell performed procedures over 24 weeks “too much to count,” and ones up to 26 weeks “very often.” When Lewis started working at the clinic, 20 first trimester abortions and five or six second-trimester abortions typically were performed per night. But in the last few years, she testified, Gosnell increasingly saw out-of-state referrals, which were all second-trimester, or beyond. By these estimates, Gosnell performed at least four or five illegal abortions every week. When a detective asked the doctor what percentage of the fetuses – including the first- and second-trimester fetuses – found at the facility during the February 2010 raid were beyond 24 weeks, Gosnell himself estimated “ten or twenty percent at the most.”
The Philadelphia medical examiner analyzed the remains of 45 fetuses seized from the clinic. Of these, 16 were first-trimester; 25 were second-trimester, ranging from 12 to 21 weeks; 2 were 22 weeks; 1 was 26 weeks; and 1 was 28 weeks. The raid took place on a Thursday, so the clinic’s busiest day for late-term abortions – Saturday – was not included.
Gosnell’s former employees testified that they knew many abortions were performed beyond 24 weeks because they had performed ultrasounds that established gestational ages greater than the 24-week legal limit. When this happened, they would tell Gosnell, and he would often redo the ultrasound, or staff members would be ordered to do so, to produce a different gestational age to record in the patient’s file. Gosnell taught his employees how to manipulate the ultrasound machine to get a false reading – one that would make the fetus appear to be smaller, and younger, than it actually was.
Latosha Lewis testified:
Q: Did anybody ever show you how to manipulate an ultrasound?
Q: Who did?
A: Dr. Gosnell.
Q: When did he do that?
A: I’m not accurate with the dates, but I would say since I’ve been there maybe, the second time I came back ’03,’04 maybe.
Q: How were you instructed to manipulate the ultrasound and for what purpose?
A: Basically to manipulate an ultrasound if the woman was laying flat, if you just want an accurate ultrasound, you would just place it on the patient’s stomach and you would measure. If you want to adjust the measurements, you would just lift off the ultrasound a little bit, which you would just make the head look a little smaller. So you would want to measure it, the measurements would be smaller.
Q: Would that make the gestational age of the fetus younger?
Q: For what purpose was that?
A: By state law we were only allowed to go up to 24 weeks in a procedure. And a lot of times we would have females that were past 24 and a half weeks. So we manipulate the 81 measurement of the ultrasound, so that indeed that we would try to get the patient to be at the 24-week mark. So we could still perform the procedure even though we were past 24 weeks.
Q: How often would he do this?
A: Very often.
Lynda Williams told the FBI that “Gosnell dummies paperwork and he will redo ultrasounds over himself to manipulate the image to reflect fetuses at younger ages.” Kareema Cross and Tina Baldwin testified that they also manipulated ultrasound results at Gosnell’s direction. They told of other instances in which Gosnell replaced ultrasound photos that they had put in patient files. If their photos showed a biparietal diameter, a measurement of the fetus’s skull, corresponding to a gestational age above 24 weeks, Gosnell simply substituted a different photo showing a measurement consistent with a younger fetus. Ashley Baldwin testified that she saw Gosnell manipulate ultrasound results himself “a good ten times.”
Tina Baldwin testified that sometimes Gosnell would manipulate ultrasounds for women who were within the 24-week legal limit so that he could charge them more. “From 15 weeks to 24 weeks then, you’re talking about money and you’re talking about making it, moving it to make it bigger and smaller.” Gosnell charged his patients on a sliding scale based not on gestational age, with late-term abortions sometimes costing $2,500 or more.
Lewis and Massof both testified that they believed Gosnell dealt with some of the patients with the longest-term pregnancies on Sundays, when his staff was not at the clinic. When Massof came in on Monday mornings he would find bloody instruments in the sink even though they had all been cleaned before the facility closed on Saturday night. When Massof asked Gosnell if he had seen patients on Sunday, the doctor answered, according to Massof: “Oh, yes, I took care of it. I had my wife or somebody help me or whatever.” Gosnell’s wife Pearl confirmed that she assisted her husband with procedures on Sundays.
Steve Massof told the jurors that when the ultrasound showed that the fetus was beyond 24 weeks, the staff would give the chart to Gosnell for him to “counsel” the patient. It is not clear that Gosnell ever counseled these patients. However, he did negotiate the price, because he charged more for women with pregnancies beyond 24 weeks. Latosha Lewis testified that Gosnell would still perform abortions on these patients. She rarely, if ever, saw Gosnell decline to do a procedure because a woman was too far along. Massof said that even if the ultrasound showed a fetus was 24 weeks, it would often be a week or two older by the time the procedure was done because “they would have to get their money.”
Kareema Cross told us, “If it’s a big baby, he [Gosnell] never tell us the truth.” Instead, “He’ll always say the baby was 24.5.” According to his workers, Gosnell recorded any fetus over 24 weeks as “24.5” weeks on their charts. The fetus could be 26 or 28 weeks, but on the chart, the doctor would always write 24.5. They testified that he told them 24.5 weeks was the legal limit. Yet, because Gosnell regularly recorded late term abortions as 24.5 weeks, his own notations prove that he performed numerous illegal abortions in violation of Pennsylvania’s 24-week limit.
Sometimes, where the gestational age exceeded the 24-week limit, Gosnell forgot – or did not bother – to include a manipulated ultrasound in the file. Instead, even where the only ultrasound established a gestational age greater than 24 weeks, Gosnell performed an abortion anyway, indicating, in the patient’s file, that the patient was exactly 24.5 weeks pregnant.
Law enforcement officers seized some abortion patient files from Gosnell’s clinic. Between the time that law enforcement raided Gosnell’s office in February and the time that investigators returned with a warrant to seize patient files, many files had disappeared. The Grand Jurors viewed a videotape of the February 2010 raid and saw files on shelves outside the procedure rooms and along a hallway. Those shelves and that hallway were empty when investigators returned. Lewis and others told us that these were second-trimester files. Most of the second-trimester files from 2008, 2009, and 2010 remain missing. The Grand Jury, reviewing just the fraction of Gosnell’s abortion files seized by authorities, was still able to document numerous instances in which ultrasound readings were manipulated to disguise illegal late-term abortions. Our review, although limited by the disappearance of many patient files, revealed that Gosnell reported performing abortions on 24.5-week fetuses more than 80 times between 2007 and
Clinic staff testified that Gosnell took patients files home and did not keep records of most of his late-term abortions at the clinic. Tina Baldwin explained that Gosnell took second-trimester files home “if there were difficult cases or some cases where he thought they shouldn’t be in there.” Massof told us that Gosnell always took files home, so “I think he has them. If he hasn’t destroyed them, he has them.” A subsequent search of Gosnell’s home and car turned up only some of these files. One of the files seized from Gosnell’s car was partially shredded.