Kermit Gosnell Grand Jury Excerpts: “Gosnell and his staff tried to cover up what drugs were administered, who administered them, when, and how”

By Dave Andrusko

Page1re-216x300Today ends the fourth week of the murder trial of abortionist Kermit Gosnell. In today’s post we complete excerpts from the Grand Jury report that alleged horrific neglect on the part of Gosnell and his untrained staff resulting in the death of a 41-year old woman in 2009–and then tried to cover it up. The following comes from Section V which is titled, “The Death of Karnamaya Mongar.”

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Gosnell and his staff tried to cover up what drugs were administered, who administered them, when, and how.

The evidence indicates that Sherry West made false entries on Mrs. Mongar’s file before handing it over to the Hospital of the University of Pennsylvania. Ashley Baldwin testified that the paramedics asked for Mrs. Mongar’s file so they could take it with them.

Williams, West, and Gosnell all contradicted themselves and each other about how much medication Mrs. Mongar received, who gave it to her, when, and even how. The file notations indicated that Mrs. Mongar received 10 mg. Demerol, 0.6 cc (cubic centimeters) promethazine, and 1 cc. diazepam at 8:14 p.m., followed by another dose of 10 mg. Demerol, 0.6 cc promethazine, and 2 cc diazepam at 10:45 p.m. An entry made by West in the clinic logbook, however, indicated that Mrs. Mongar was given a much larger dose: 75 mg. Demerol, 12.5 mg. promethazine, and 10 mg. diazepam.

Lynda Williams was interviewed by law enforcement on the night of the February 2010 raid. At first, she told her interviewers that she did not put IVs in patients, that Gosnell administered the medication, and that she thought he gave a “heavy” dose (50 mg. Demerol, 12.5 mg. promethazine, and 5mg. diazepam). When pressed to tell the truth, Williams changed her story, admitting that she had administered the anesthesia. She insisted, however, that she had called Gosnell before administering 10 mg. Demerol and 12.5 mg. promethazine at 6:00 p.m., and an additional “custom” dose (75 mg. Demerol, 12.5 mg. promethazine, and 10 mg. diazepam) when the “local anesthesia” wore off. She said that she injected these medications into the patient’s arm.

Dr. Herlich, the University of Pittsburgh Medical Center anesthesiologist, testified that the first dose of Demerol described by Williams made no sense –that there is no such thing as a 10 mg. dose of Demerol. He further explained that a 10 mg. dose of Demerol, if it existed, “would be barely noticeable in terms of pain control” in the average adult. The dosage Williams claimed had been administered would not, in any case, have had the effect witnessed by Mrs. Mongar’s daughter. She said that her mother had been in a lot of pain in the recovery room before the procedure, but that the medicine administered intravenously by Williams and West put her mother “to sleep.”

It is notable that Williams’s story was different from the one given by Gosnell when he was interviewed by Detective James Wood, the FBI, and the DEA on the night of the raid. According to Detective Woods’s notes, Gosnell first told his interviewers that medication was given by “one of his nurses or by a medical assistant, he wasn’t sure who …” –even though no nurses were employed in the clinic. He then said that during the “evening,” before the procedure, “one of the nursing staff” administered an unspecified dose of Demerol and diazepam (not promethazine) intramuscularly (meaning an injection into a muscle rather than a vein – which would be intravenous). He said that he then administered a dose of Demerol intravenously when he did the abortion procedure.

He also told the DEA that he had performed a “successful and uneventful . .. suction and curette procedure”–even though Mrs. Mongar’s 19-week-old fetus was found in the clinic’s freezer completely intact. Gosnell’s statements to law enforcement contradicted what he had earlier reported to the Department of Health shortly after Mrs. Mongar’s death. On November 26, 2009, Gosnell wrote a letter to health department officials advising them of his patient’s death.

At that time, he reported that Mrs. Mongar had been given two doses of sedation intravenously, each containing 50 mg. of Demerol and 5 mg. of diazepam. He did not say who had administered this mix of drugs, which he called “customary.” All the evidence is to the contrary: This combination of drugs was nowhere listed on the clinic’s medication chart, and every other staff member stated that the final dose given to every second trimester patient was 75 mg. Demerol, 12.5 mg. promethazine, and 10 mg. diazepam.

Kareema Cross explained to the Grand Jury why it was significant that Williams, as opposed to the doctor, had given Mrs. Mongar the lethal drugs. Cross said that Williams had confided in her that Gosnell was willing to say that he had administered the drugs. Cross testified that “Dr. Gosnell told her that she’s not going to be in trouble. He’s going to say that he gave the patient the medication.” Asked why this mattered, Cross said:

A. Because she’s not certified, none of us are certified to do it.

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Q. But if he gave the medicine, was it your understanding that no one would get in any trouble because he’s a doctor?

A. Right.

Q. And it would just be malpractice; is that right?

A. Yes

Q. And not criminal; is that right?

A. Yes.

Q. Is that how it was told to you?

A. Yes.

Q. Is that how Lynda [Williams] explained it to you?

A. Yes

In fact, according to Cross, Gosnell rarely gave medication; he almost always left this task to his untrained and uncertified workers.

The toxicology expert’s testimony flatly contradicted these self-serving statements. Dr. Rohrig, the toxicology expert, explained to the Grand Jury that all of Gosnell’s, Williams’s, and West’s shifting accounts of the drugs given to Mrs. Mongar were inconsistent with the levels of medications found in Mrs. Mongar’s blood post mortem. Those levels were consistent, however, with what Kareema Cross said was the clinic’s standard practice – to give multiple doses of 75 mg. Demerol, along with promethazine and diazepam, throughout the afternoon and evening before the procedure.

The expert explained that Demerol has a “half-life” of about three hours, meaning that it takes about that long for the concentration of the drug in the body to be reduced by half. It then takes another three hours for the remaining concentration to be reduced by 50 percent, and this pattern continues until all of the drug has dissipated. Demerol is thus “fairly quickly removed from the body.” At least 18 hours after the drugs were administered, Mrs. Mongar still had a Demerol concentration of 750 micrograms per liter in her blood.

While Dr. Rohrig was unable to determine precisely how much Demerol Mrs. Mongar had been given, he testified that, based on the high concentration still in her blood, it was far more than Gosnell, Williams, and West claimed. The expert explained that if Mrs. Mongar had been given 100 mg. of Demerol (as Gosnell told the Department of Health), the peak drug concentration would have been about 300 micrograms per liter. Mrs. Mongar’s level – over 700 micrograms a day later – was totally inconsistent with  Gosnell’s, Williams’s, and West’s stories. “You just can’t have that high concentration 18 hours later… That’s enough [time] to cause the normal therapeutic doses to go to zero.” Mrs. Mongar had to have been given multiple 75-mg. doses of Demerol, or the doses she was given had to have contained well over 75 mg. of Demerol.

What Gosnell and others reported to the hospital, to the Health Department, and to law enforcement about the amount of medication they gave to Mrs. Mongar was demonstrably false.

Predictably, Gosnell and his staff also tried to avoid responsibility by blaming the victim. The day after Mrs. Mongar died, West said to Ashley Baldwin that one of the family members had told her that Mrs. Mongar “took some pills, because she was trying to get rid of it at home.” Similarly, Liz Hampton in her testimony before the Grand Jury claimed that she had had a discussion with Mrs. Mongar’s “husband and two daughters” upstairs at the clinic. Hampton insisted, under oath, that they had said to her: “we told her not to take the drugs.” But the only family members to enter the clinic were Mrs. Mongar’s daughter and the daughter’s mother-in-law, and neither of them spoke English.

Mrs. Mongar’s husband was in Virginia and Mr. Ghalley was waiting outside in the car. Mrs. Mongar’s daughter flatly denied that anyone in her group ever said any such thing. Her mother, she testified with the help of a translator, had taken nothing other than the medication given to her at the clinic the night before. Ashley Baldwin testified that she did not believe West and Hampton’s claims, because it seemed odd to be hearing about them only after the patient had to be transported to the hospital. In any event, expert testimony established that Mrs. Mongar died from an overdose of Demerol, the drug administered in Gosnell’s clinic, and not some mystery pill.

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